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Principal Investigator
Sushilkumar Sonavane
University of Alabama at Birmingham
Position Title
Associate Professor
About this CDAS Project
NLST (Learn more about this study)
Project ID
Initial CDAS Request Approval
Sep 19, 2016
The Relationship Of Cancer Characteristics And Patient Outcome With Time To Lung Cancer Diagnosis After An Abnormal Screening CT
Background: Despite advances in imaging and treatment, non-small cell lung cancer (NSCLC) is the leading cause of cancer related deaths. The cancers at earlier stages (I, II) show better 5-year survival. The National Lung Screening Trial (NLST) showed that 3 low dose CT (LDCT) screens at annual intervals resulted in a 20% reduction in lung-cancer specific mortality; further, there was a decrease in the number of advanced-stage cancers and increase in the number of early-stage lung cancers. However, even with LDCT screening, and a positive screen result, it is possible that lung cancer diagnosis may have been delayed in some instances, potentially affecting lung cancer survival and the mortality benefit of LDCT screening. Early diagnosis and treatment are considered key to improve patient outcome, though the specific effect of delayed diagnosis on outcome has not been defined.

Study Design: LDCT arm subjects with a positive baseline screen and lung cancer diagnosis within 3 years (1095 days) of that screen will be evaluated to determine if the lung cancer was likely present at the time of the baseline screen. We would like to review images of these subjects.

We will try to seek relation of CT nodule characteristics, cancer type, stage, patient survival with the time to lung cancer diagnosis.

The aim of this study is to examine, in NLST subjects with a positive baseline screen, the time to lung cancer diagnosis (TTD) from the baseline screen and its relation to cancer characteristics including CT features, histology, stage and patient survival.

Specific reason: This project actually started before the CDA website and our hard drive containing the study images crashed. Most of the analysis is done and we need to review images of about 60 subjects with known study numbers as we try to seek consensus on the nodule margins.


Paul Pinsky, PhD MPH
Division of Cancer Prevention, National Cancer Institute, Bethesda, MD

Jubal Watts, Jr., MD
Department of Radiology, University of Alabama in Birmingham, Birmingham, AL

David S. Gierada, MD
Department of Radiology, Washington University School of Medicine, St. Louis, MO

Reginald Munden, MD, DMD, MBA
Department of Radiology, Houston Methodist Hospital, Houston, TX

Satinder P. Singh, MD, FCCP
Department of Radiology, University of Alabama in Birmingham, Birmingham, AL

Hrudaya Nath, MD, FCCP, FAHA
Department of Radiology, University of Alabama in Birmingham, Birmingham, AL