Analysis of Lung Cancers Detected on CXRs and Low Dose CTs in the NLST in Women Participants

Principal Investigator

Name
Judith Amorosa

Degrees
MD

Institution
Cancer Institute of New Jersey

Position Title
Radiologist

Email
amorosa@umdnj.edu

About this CDAS Project

Study
NLST (Learn more about this study)

Project ID
201111-0045

Initial CDAS Request Approval
Nov 29, 2011

Title
Analysis of Lung Cancers Detected on CXRs and Low Dose CTs in the NLST in Women Participants

Summary
The control arm of NLST was chest X-ray according to NLST protocol. 26,732 participants received a single PA chest X-ray and 26,722 a low dose chest CT.
6.9% of the chest X-ray arm was positive and 24.2 % of the CT arm was positive. The false negative rate was lower in the chest X-ray arm, only 94.5% in comparison to 96.4% in the CT arm.
The results of the NLST showed that using low dose CT for detection of lung cancer in the 55-74 age group with smoking history of at least 30 pack-years and quitting within 15 years of the exam reduces lung cancer mortality by 20%.
So what value does the chest X-ray have for women in this same demographic group? Should every woman with a current and previous smoking history have a low dose chest CT?
572 lung cancers were detected in the chest X-ray arm, 645 in the CT arm.
It is undisputable that screening with chest X-ray does not reduce mortality secondary to lung cancer according to NLST.
We want to separate women participants and analyze the age, smoking history, other demographic data and the size, characteristics, location and stage of the 572 lung cancers diagnosed with chest X-ray and 645 lung cancers diagnosed with low dose CT and compare to the lung cancers to male participants.

According to the American Cancer Society women develop lung cancer earlier and more commonly without a smoking history than men. All women participants were smokers or ex-smokers as per protocol jn NLST.
According to some investigators, women tend to be diagnosed at earlier stage.

Collaborators

Chiles
Black
Strollo
Kazerooni
Torigian
Munden
Vydareny
Aberle