CHEST Guidelines-Invasive-Procedures-Associated-With-Lung-Cancer-Sc

Invasive-Procedures-Associated-With-Lung-Cancer-Sc

Pdf Summary

The study by Manyak et al. investigates the frequency of invasive procedures and their complications resulting from lung cancer screening (LCS) in a community-based setting. The research, conducted at a nonuniversity teaching hospital, analyzed data from 2016 to 2019 to assess procedures prompted by LCS results, including those for false-positive and benign incidental findings. Of 2,003 LCS participants, 58 were diagnosed with lung cancer and 71 with any malignancy. Invasive procedures were carried out 160 times in 103 participants, accounting for 5.1% of the cohort, with a small fraction performed on those without malignancy mainly for false-positive nodules or incidental non-malignant but clinically significant findings.<br /><br />The study found a low rate of invasive procedures for false-positive findings (0.4% of participants). Incidental benign findings resulted in procedures for 0.9% of participants, most of which proved clinically beneficial by leading to treatment or changes in management. The complication rate in non-malignant cases was minimal, at just 0.15%. High adherence to management algorithms like the Lung Imaging Reporting and Data System (Lung-RADS) and a multidisciplinary approach helped keep invasive procedure rates low.<br /><br />This study underscores the potential for LCS programs to manage false-positive findings safely and effectively in real-world settings beyond clinical trials. By comparing their findings with past trials, the authors noted improved outcomes potentially due to a multidisciplinary approach and better nodule management protocols, minimizing unnecessary invasive interventions while maintaining effective cancer diagnosis and care. The study advocates for standardized approaches to incidental findings to prevent unnecessary invasive procedures, offering valuable insights into the optimization of community-based LCS programs.

Keywords

lung cancer screening

invasive procedures

false-positive findings

community-based setting

Lung-RADS

multidisciplinary approach

nodule management

incidental findings

complication rate

nonuniversity teaching hospital