title: Experience with a CT screening program for individuals at high risk for developing lung cancer.
abstract: OBJECTIVE
  The aim of this study was to compare results of National Comprehensive Cancer Network (NCCN) high-risk group 2 with those of NCCN high-risk group 1 in a clinical CT lung screening program.
  
  
  METHODS
  The results of consecutive clinical CT lung screening examinations performed from January 2012 through December 2013 were retrospectively reviewed. All examinations were interpreted by radiologists credentialed in structured CT lung screening reporting, following the NCCN Clinical Practice Guidelines in Oncology: Lung Cancer Screening (version 1.2012). Positive results required a solid nodule ≥4 mm, a ground-glass nodule ≥5 mm, or a mediastinal or hilar lymph node >1 cm, not stable for >2 years. Significant incidental findings and findings suspicious for pulmonary infection were also recorded.
  
  
  RESULTS
  A total of 1,760 examinations were performed (464 in group 2, 1,296 in group 1); no clinical follow-up was available in 432 patients (28%). Positive results, clinically significant incidental findings, and suspected pulmonary infection were present in 25%, 6%, and 6% in group 2 and 28.2%, 6.2%, and 6.6% in group 1, respectively. Twenty-three cases of lung cancer were diagnosed (6 in group 2, 17 in group 1), for annualized rates of malignancy of 1.8% in group 2 and 1.6% in group 1.
  
  
  CONCLUSIONS
  NCCN group 2 results were substantively similar to those for group 1 and closely resemble those reported in the National Lung Screening Trial. Similar rates of positivity and lung cancer diagnosis in both groups suggest that thousands of additional lives may be saved each year if screening eligibility is expanded to include this particular high-risk group.
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts. Electronic address: brady.mckee@lahey.org.
authors.forename: Brady J
authors.initials: BJ
authors.lastname: McKee
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Hashim
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: French
authors.affiliation: Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: McKee
authors.affiliation: Department of Hematology and Oncology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Hesketh
authors.affiliation: Department of Pulmonary and Critical Care, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Carla R
authors.initials: CR
authors.lastname: Lamb
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Christina
authors.initials: C
authors.lastname: Williamson
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Flacke
authors.affiliation: Department of Radiology, Lahey Hospital & Medical Center, Burlington, Massachusetts.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wald
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
keywords: CT lung screening; Lung-RADS; NCCN