A CT lung cancer screening program that also offered abdominal non-contrast CT scans detected a large number of abnormalities outside the lung in a population of people with smoking histories. The combined approach could offer a more efficient way to detect multiple pathologies in a single patient visit.
CT lung cancer screening is gaining momentum globally, but clinicians and researchers continue to look for ways to make it more valuable.
- That’s a good thing, because smoking is a risk factor not just for lung cancer, but also other pathologies like abdominal aortic aneurysm (AAA) – so why not screen for those at the same time?
In a paper in European Urology, U.K. researchers describe their Yorkshire Kidney Screening Trial (YKST), which sought to detect kidney cancer by piggybacking on the county’s existing CT lung cancer screening program.
- Abdominal non-contrast CT exams were offered at the same time as thoracic CT lung screening scans to high-risk people who met the lung program’s screening criteria, namely aged 50-85 and more than 30 pack-years of smoking history.
In all, 4k people accepted the offer to get additional abdominal CT scans, which had the following findings …
- 64% of patients had normal findings, while another 20% had images that required additional review but no further action.
- 5.3% had a new serious finding.
- Serious findings were broken down as follows: renal stones ≥ 5 mm (3%), AAA (1.5%), renal mass/complex cysts (0.62%), kidney cancers (0.25%), and other cancers (0.25%).
- It took 13 minutes of additional time to perform the abdominal CT scan.
Researchers said the prevalence of additional disease in YKST was within the range of other U.K. screening programs, such as for colorectal cancer (0.16-0.61%) and breast cancer (0.92%).
- The high prevalence of AAA was “unexpected,” especially since many AAA cases were found in people who aren’t covered by existing AAA screening programs.
The Takeaway
As with recent research combining CT lung screening with coronary artery calcium (CAC) scoring, the new study shows that lung screening offers an opportunity to screen for more than just lung cancer. By detecting additional disease, combo screening has the potential to flip the script when it comes to screening’s cost-benefit ratio.
