Patterns of recurrence among adults diagnosed with screen-detected lung cancer

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-02-18 DOI:10.1016/j.canep.2025.102777

Nikki M. Carroll , Jennifer Eisenstein , Kris F. Wain , Jared M. Freml , Robert T. Greenlee , Stacey A. Honda , Christine Neslund-Dudas , Katharine A. Rendle , Anil Vachani , Debra P. Ritzwoller

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Abstract

Background

With the recent shift in lung cancer staging towards early-stage disease coinciding with the introduction of lung cancer screening (LCS), little is known if LCS has affected the rate of recurrence and survival in community settings. Our objective was to evaluate variation in the detection and outcomes of recurrent lung cancer stratified by receipt of LCS.

Methods

Patients aged 55–80 years old diagnosed with stage I-IIIA non-small cell lung cancer (NSCLC) between 1/1/2014 and 12/31/2020 who completed definitive therapy and were considered disease-free were identified. Rates of recurrence were calculated in discrete 12-month intervals and by cumulative incidence. Survival was evaluated by multivariable adjusted Restricted Mean Survival Time (aRMST). Factors associated with recurrence were evaluated by Poisson models.

Results

Among 916 patients meeting study criteria, 708 (77 %) were non-screen-detected and 208 (23 %) were considered screen-detected. The proportion of recurrence between non-screen-detected (22 %) and screen-detected (17 %) was similar (P = 0.11). Recurrence rates during the first and second years after definitive therapy were 10.1 and 4.1 per 100 person-years for the non-screen-detected and 6.0 and 4.5 per 100 person-years for screen-detected, respectively. Two-year cumulative incidence of recurrence was 16.5 % (95 % CI, 13.9 %-19.4 %) for non-screen-detected patients and 13.8 % (95 % CI, 9.3 %-19.0 %) in the screen-detected group. Recurrence-free survival and survival after recurrence were similar between the two groups. Screening status was not associated with the likelihood of recurrence (RR=0.94, 95 % CI, 0.59–1.50).

Conclusion

These findings provide evidence of recurrence being a part of the intrinsic nature of disease progression despite mode of detection. Our findings emphasize the need for all patients to receive surveillance and survivorship care after treatment for early-stage NSCLC regardless of mode of detection. Further study with longer follow-up is warranted.

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.