Lung Cancer Screening Model Improves Positive Predictive Value

Posted by Lewisville Flower Mound Oncology Group on May 22nd, 2019

A study published in the Journal of the American College of Radiology found that researchers can improve lung cancer screening predictive ability and look at characteristics specific to each patient without altering the sensitivity of low-dose helical computed tomography (CT) that was used in the National Lung Screening Trial (NLST). The NLST found that the use of low-dose CT for the annual screening of those considered to be at a high risk of developing lung cancerled to a 6.7 percent reduction in overall mortality rates and a 20 percent decrease in lung cancer-specific mortality.

The study pointed out several things including:

• Applying NLST across the board covers a large number of lung nodules. This leads to a high number of false-positive lung cancer results. The immediate implication on the sector is the need for a higher budget. It also causes undue psychological stress on the patients and possible additional costs on invasive procedures and other resulting complications.

• The researchers developed a model that includes patient characteristics and nodule-level featuresto help distinguish between benign and malignant lung nodules, with a sensitivity value of 93.6 percent, similar to the NLST. The patient characteristics considered include gender, age, cancer history, race, family cancer history, smoking pack-years and current smoking status.

• They reviewed over 32,000 nodules from 9,728 patients and found that the positive predictive value was more than double that of the NLST at almost 8 percent. 639 of the nodules were malignant and 90 percent of these were accurately diagnosed as positive. The model used accurately gave a positive diagnosis for 94 percent of subjects at the individual level.

The statistics may look like a huge difference but translating these to real life figures may not look like much. The findings will, however, affect and guide the implementation of different clinical decisions as time goes on.

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Lewisville/Flower Mound Oncology Group, a division of Choice Cancer Care – is an independently owned and operated oncology practice that is completely focused on unique, comprehensive patient care.