Five-year outcome of lung cancer detection in patients with and without airflow obstruction in a primary care outpatient practice.
BACKGROUND
We have previously published the outcome of a community-based lung cancer screening program. We now report on the 5-year follow-up of this study and include both patients with and without airflow obstruction.


METHODS
One thousand two hundred fifty-six patients completed questionnaires in the office of their primary care physicians, and 430 of this group were assessed to be at high risk for lung cancer. These patients then underwent spirometry, and 88 of 126 patients with airflow obstruction consented to lung cancer screening test. TESTING METHODS: Complete screening testing included spirometry, two-view chest radiograph, chest CT scan, and sputum cytology examinations.


RESULTS
Eight lung cancers were found in the high-risk group with airflow obstruction. No more cancers were found in the tested group in the 5 years since the earlier report. Ten cancers were found in the 304 patients with normal airflow, not previously reported. In all, 18 lung cancers were found in 430 patients deemed at risk by a simple one-page questionnaire (4.2%).


CONCLUSIONS
A questionnaire, self-administered in a primary care office setting, helps identify patients at high risk of lung cancer. If upcoming results of randomized controlled trials show a benefit of lung screening, this tool could be of help to select patients for screening.
Bechtel
Joel J
JJ
Pulmonary Medicine, St Mary's Hospital, Grand Junction, Colorado, USA.
Kelley
William A
WA
Coons
Teresa A
TA
Mohler
Philip
P
Mohler
Andrew
A
James
David
D
Petty
Thomas L
TL
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D003120:Colorado / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000379:methods*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D013902:Radiography, Thoracic / Q000379:methods*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*