Computed tomography screening for lung cancer preliminary results in a diverse urban population

Hannah Milch, Mark Kaminetzky, Pamela Pak, Alla Godelman, Anna Shmukler, Tova C. Koenigsberg, Linda B. Haramati

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The purpose of this study was to describe the baseline characteristics and results of the initial 18 months of our clinical computed tomography (CT) lung cancer screening program in an ethnically diverse, poor, predominantly overweight, and obese population, which differs dramatically from the National Lung Screening Trial population. Materials and Methods: All patients had a physician referral for CT lung cancer screening and met National Lung Screening Trial eligibility criteria. Infrastructure developed for the program included a standardized results report [Bronx score of 1 to 5 (modeled on BIRADS)] for the electronic medical record and a dedicated bilingual screening coordinator. If the patient's insurance did not cover CT screening, a fee of 75 was charged. Results: A total of 320 patients [54% (174) men, mean age 64 y] underwent initial CT lung cancer screening from December 18, 2012 to July 3, 2014. The median pack-years was 47, and 68% (218) were current smokers. Twenty-six percent (84) were white, and 70% (223) were overweight (101) or obese (122). The lung cancer prevalence was 2.2% (7/320). Seventy-eight percent (7/9) of patients with CT findings positive for lung cancer (score 5a, 5b) had proven lung cancer; 1 had stage 1 (1B) disease, and 6 had stage IIA or higher disease. The falsepositive rate for a Bronx score Z3 was 19% (60). Medicare and Medicaid insure 80% of the institution's overall population but only 38% (121) of the CT screening patients. Conclusions: CT screening is feasible in a diverse inner-city population with the support of a robust infrastructure. Further study is needed to determine whether CT screening will confer a mortality benefit in this population.

Original languageEnglish (US)
Pages (from-to)157-163
Number of pages7
JournalJournal of Thoracic Imaging
Volume30
Issue number2
DOIs
StatePublished - Mar 6 2015

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Urban Population
Lung Neoplasms
Tomography
Early Detection of Cancer
Population
Lung
Fees and Charges
Electronic Health Records
Medicaid
Medicare
Insurance
Referral and Consultation
Physicians
Mortality

Keywords

  • computed tomography
  • lung cancer
  • lung cancer screening
  • the Bronx

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Cite this

Computed tomography screening for lung cancer preliminary results in a diverse urban population. / Milch, Hannah; Kaminetzky, Mark; Pak, Pamela; Godelman, Alla; Shmukler, Anna; Koenigsberg, Tova C.; Haramati, Linda B.

In: Journal of Thoracic Imaging, Vol. 30, No. 2, 06.03.2015, p. 157-163.

Research output: Contribution to journalArticle

Milch, Hannah ; Kaminetzky, Mark ; Pak, Pamela ; Godelman, Alla ; Shmukler, Anna ; Koenigsberg, Tova C. ; Haramati, Linda B. / Computed tomography screening for lung cancer preliminary results in a diverse urban population. In: Journal of Thoracic Imaging. 2015 ; Vol. 30, No. 2. pp. 157-163.
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