Delays in follow-up are common in people at high risk for lung cancer

The results are concerning, study presenter Dr. Alwiya Ahmed of the University of Washington in Seattle said in a statement released by the company.

“The fact that almost half of all patients with abnormal results in our study experienced delays in follow-up is alarming,” she said. “It is disconcerting that among people screened who have abnormal results, there is a significant delay in recommended follow-up. This could ultimately lead to delayed diagnosis of lung cancer.”

Lung cancer is the leading cause of cancer-related deaths, Ahmed noted. Lung screening with low-dose CT scans reduces mortality in high-risk individuals, and the US Preventive Services Task Force (USPSTF) and the US Centers for Medicare and Medicaid Services (CMS) have recently expanded the pool of eligibility for annual screening.

Researchers have begun to explore why, despite these expanded recommendations, uptake of CT lung cancer screening remains slow, but no studies assess the delay in follow-up after high-risk findings, Ahmed and colleagues wrote. in their study summary. And while the group didn’t directly investigate the causes of delays in follow-up care, those causes could include “comorbidities that would preclude someone from being a candidate for surgery or chemotherapy options, status current smoker, safety clinics, gender, distance to clinic,” Ahmed said.

To address this knowledge gap, Ahmed’s team conducted a study including patients who underwent baseline or annual screening between 2012 and 2021; 397 people had high-risk results according to the Lung-RADS categorization. Follow-up care was defined as a second CT scan or other appropriate imaging, and/or specialist consultation or intervention. The investigators defined delayed follow-up as any follow-up that occurred 30 days or more beyond the recommended period.

Of the 397 patients with high-risk findings on baseline/screening CT, 15% were diagnosed with lung cancer. A total of 47% of high-risk exams had statistically significant follow-up delays, and the median delay for all suspicious Lung-RADS categories was three months.

Delays to follow-up after baseline suspicious results on CT lung cancer screening
Category Lung-RADS Percentage of delays Median follow-up (days)
Lung-RADS 3 58% 181
Lung-RADS 4A 35% 68
Lung-RADS 4X 37% 32

The researchers also found that patients who were current smokers had longer delays than former smokers – a finding “concerning given the high risk of lung cancer in this group”, they noted.

“Interventions are needed at both the provider and patient levels to ensure that high-risk patients receive adequate follow-up,” Ahmed concluded in the ATS statement.

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