Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry
Introduction: Given that an incidental pulmonary nodule (IPN) on chest computed tomography (CT) may represent nascent lung cancer, timely follow-up imaging is critical to assess nodule growth and the need for tissue sampling. We previously reported our institution’s systematic process to identify an...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364322000212 |
| _version_ | 1828857307541274624 |
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| author | Laurie L. Carr, MD Debra S. Dyer, MD Pearlanne T. Zelarney, MS Elizabeth O. Kern, MD, MS |
| author_facet | Laurie L. Carr, MD Debra S. Dyer, MD Pearlanne T. Zelarney, MS Elizabeth O. Kern, MD, MS |
| author_sort | Laurie L. Carr, MD |
| collection | DOAJ |
| description | Introduction: Given that an incidental pulmonary nodule (IPN) on chest computed tomography (CT) may represent nascent lung cancer, timely follow-up imaging is critical to assess nodule growth and the need for tissue sampling. We previously reported our institution’s systematic process to identify and track patients with an IPN associated with improved CT on follow-up. We hypothesized that this improvement may have led to a higher frequency of early-stage lung cancer. To evaluate this, we performed a study to determine whether cases of early-stage lung cancer were more likely to have had our tracking system applied to suspicious findings. Methods: An observational study was performed by identifying cases of lung cancer that were detected as IPNs on chest CT scans performed at our institution, from 2006 to 2016. A total of 314 cases were dichotomized into early-stage (stage 1) or late-stage (stages II to IV) disease. A multivariant regression analysis with modeling was used to determine factors associated with a diagnosis of early-stage disease. Factors included the use of the tracking system and nodule registry. Results: The following factors were independently associated with early-stage lung cancer: index nodule diameter, (OR = 0.971, confidence interval [CI]: 0.948–0.995], p = 0.016), adenocarcinoma histology (OR = 2.930 [CI: 1.695–5.064], p = 0.0001) and use of tracker phrases on CT reports (OR = 1.939 [CI: 1.126–3.339], p = 0.016). Conclusions: The application of a patient tracking system and computerized lung nodule registry lead to an increased frequency in the diagnosis of stage 1 NSCLC from IPNs. This is a meaningful outcome for patients and should be adapted for IPN management. |
| first_indexed | 2024-12-13T01:34:02Z |
| format | Article |
| id | doaj.art-61b7ed91e5f5413c9c23f4c27f20bf0b |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-12-13T01:34:02Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-61b7ed91e5f5413c9c23f4c27f20bf0b2022-12-22T00:03:56ZengElsevierJTO Clinical and Research Reports2666-36432022-03-0133100297Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized RegistryLaurie L. Carr, MD0Debra S. Dyer, MD1Pearlanne T. Zelarney, MS2Elizabeth O. Kern, MD, MS3Division of Oncology, Department of Medicine, National Jewish Health, Denver, Colorado; Corresponding author. Address for correspondence: Laurie L. Carr, MD, Division of Oncology, Department of Medicine, National Jewish Health, 1400 Jackson Street, J328, Denver, CO 80207.Department of Radiology, National Jewish Health, Denver, ColoradoResearch Informatics Services, National Jewish Health, Denver, ColoradoDivision of Medical, Behavioral, and Community Health, Department of Medicine, National Jewish Health, Denver, ColoradoIntroduction: Given that an incidental pulmonary nodule (IPN) on chest computed tomography (CT) may represent nascent lung cancer, timely follow-up imaging is critical to assess nodule growth and the need for tissue sampling. We previously reported our institution’s systematic process to identify and track patients with an IPN associated with improved CT on follow-up. We hypothesized that this improvement may have led to a higher frequency of early-stage lung cancer. To evaluate this, we performed a study to determine whether cases of early-stage lung cancer were more likely to have had our tracking system applied to suspicious findings. Methods: An observational study was performed by identifying cases of lung cancer that were detected as IPNs on chest CT scans performed at our institution, from 2006 to 2016. A total of 314 cases were dichotomized into early-stage (stage 1) or late-stage (stages II to IV) disease. A multivariant regression analysis with modeling was used to determine factors associated with a diagnosis of early-stage disease. Factors included the use of the tracking system and nodule registry. Results: The following factors were independently associated with early-stage lung cancer: index nodule diameter, (OR = 0.971, confidence interval [CI]: 0.948–0.995], p = 0.016), adenocarcinoma histology (OR = 2.930 [CI: 1.695–5.064], p = 0.0001) and use of tracker phrases on CT reports (OR = 1.939 [CI: 1.126–3.339], p = 0.016). Conclusions: The application of a patient tracking system and computerized lung nodule registry lead to an increased frequency in the diagnosis of stage 1 NSCLC from IPNs. This is a meaningful outcome for patients and should be adapted for IPN management.http://www.sciencedirect.com/science/article/pii/S2666364322000212Incidental pulmonary nodulesLung cancer screeningLung nodule follow-upLung nodule registry and tracking |
| spellingShingle | Laurie L. Carr, MD Debra S. Dyer, MD Pearlanne T. Zelarney, MS Elizabeth O. Kern, MD, MS Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry JTO Clinical and Research Reports Incidental pulmonary nodules Lung cancer screening Lung nodule follow-up Lung nodule registry and tracking |
| title | Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry |
| title_full | Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry |
| title_fullStr | Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry |
| title_full_unstemmed | Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry |
| title_short | Improvement in Stage of Lung Cancer Diagnosis With Incidental Pulmonary Nodules Followed With a Patient Tracking System and Computerized Registry |
| title_sort | improvement in stage of lung cancer diagnosis with incidental pulmonary nodules followed with a patient tracking system and computerized registry |
| topic | Incidental pulmonary nodules Lung cancer screening Lung nodule follow-up Lung nodule registry and tracking |
| url | http://www.sciencedirect.com/science/article/pii/S2666364322000212 |
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