title: Free Lung Cancer Screening Trends Toward a Twofold Increase in Lung Cancer Prevalence in the Underserved Southeastern United States.
abstract: The National Lung Screening Trial (NLST) reported that the prevalence of lung cancer in individuals at high risk for the disease is 1%, and that screening these individuals using low-dose helical computed tomography of the chest saves lives. To increase screening accessibility in the underserved southeastern United States, we developed a free lung screening program, modeled after the Lahey Hospital & Medical Center Free Lung Screening Program, for individuals meeting National Comprehensive Cancer Network high-risk criteria.
  
  
  
  This was a chart review of 264 participants screened in the first year of our program. Participants were divided into categories based on the Lung Imaging Reporting and Diagnostic System. Categories three and four were considered positive findings, with demographic and disease criteria collected on these patients.
  
  
  
  Of 264 participants screened, 28 (10.6%) were Lung Imaging Reporting and Diagnostic System category four, 23 (8.7%) were category three, 78 (29.5%) were category two, and 135 (51.1%) were category one. Eight of the 264 participants (3.0%) had lung cancer, with 75% detected in early stages.
  
  
  
  We found a lung cancer prevalence in our high-risk screened population of 3.0% (8 of 264). After adjusting for patients who were symptomatic on clinical evaluation, we report a prevalence of cancer at 2.2% compared with 1.1% in the first year of the National Lung Screening Trial and a prevalence of 1.9% versus 0.6% compared with the National Comprehensive Cancer Network criteria in the first 10 months at Lahey Hospital & Medical Center. This study justifies low-dose helical computed tomography screening in high-risk regions because lung cancer treatment before symptoms appear is more effective, and the prevalence of disease in the detectable preclinical phase is high.
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Erika L
authors.initials: EL
authors.lastname: Simmerman
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Norman B
authors.initials: NB
authors.lastname: Thomson
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Dillard
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Zhonglin
authors.initials: Z
authors.lastname: Hao
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Ramses F
authors.initials: RF
authors.lastname: Sadek
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Samir N
authors.initials: SN
authors.lastname: Khleif
authors.affiliation: From the Department of Surgery, the Department of Radiology and Imaging, the Department of Medicine/Division of Pulmonary Critical Care, the Department of Medicine/Division of Hematology/Oncology, and the Georgia Cancer Center, Augusta University, Augusta.
authors.forename: Carsten
authors.initials: C
authors.lastname: Schroeder
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000191:economics*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008507:Medically Underserved Area; D008875:Middle Aged; D015995:Prevalence; D036542:Tomography, Spiral Computed