Junjia Zhu

Ph.D.

Penn State Hershey Medical Center

Assistant Professor

NLST (Learn more about this study)

NLST-113

Jan 16, 2015

Using NLST Data to find the Relationships between Nicotine Dependence Variables and CT Screening Efficacy as well as Survival Outcomes

(Background) The National Lung Screening Trial (NLST) is a randomized controlled trial conducted at 33 US sites. The main objective of this trial is to compare lung cancer mortality among persons screened with reduced dose helical computerized tomography (CT) and among persons screened with chest radiograph. The NLST enrolled a total of 53,454 individuals at the time of randomization and about 50% of them were assigned to each one of the study arms. About 27.3% of the participants in the CT group and 9.2% in the radiograph group had positive results after the initial screening (T0). This trial has been completed. The data collection has ended, and information is complete through December 31, 2009. There are rich amount of information about NLST available through National Cancer Institute (NCI) website including participant’s characters, screening data, lung cancer data, progression and mortality data for lung cancer patients.

Eligible participants for the NLST were smokers at high risk of lung cancer, including smokers of least 30 pack-years. Emerging data indicate that even among heavy smokers, other smoking characteristics are related to lung cancer risk and may identify an even higher risk group than just heavy smokers. In this proposed study we are mainly interested in studying the relationship between nicotine dependence variables (e.g. time to first cigarette since waking up) in relation to CT screening efficacy and survival outcomes. Specifically we plan to use the following datasets:
- Participant’s baseline information (demographics, health status, and family history)
- Smoking status and nicotine dependence information
- Progression and Mortality data (for participants who had lung cancer only)

Specific Aim 1: Determine the relationship between nicotine dependence variables and testing positive in the initial screening test (T0) vs. testing negative. The analysis will be stratified by the screening method (low-dose CT versus radiography).

Specific Aim 2: for those individuals who had confirmed diagnosis of lung cancer (288 cases in the low-dose CT group and 185 cases in the radiography group), compare the overall survival and progression survival among initial time to first cigarette categories.