Association between Clinic Characteristics and Positive Low-dose CT outcome among current and Former Smokers Open Access

Wu, Mengdi (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/dv13zt615?locale=en
Published

Abstract

Background: Lung cancer is one of the leading cause of death now in the United States. According to Cancer statistics reported by Greenlee et al. in 2000, 28% of death were due to lung cancer among deaths due to cancer in United States. Lung Imaging Reporting and Data System (Lung-RADS) is a scoring system developed by American College of Radiology to help better interpret CT screening and manage lung cancer diagnosis based on the screening characteristics.

Objective: The aim of the study is to identify clinic factors that associated with change of screening classification during screening trials and further modify current screening procedures.

Method : Univariate and Multivariate analysis were applied to identify potential risk factors that would be associated with suspicious lung screening outcomes. Model selection were based on deviance analysis.

Results: The results indicated that heavy smokers with current or past smoking behaviors, increasing age would lead to potential risk of detection of malignant nodules at the time of screening. Male smokers would be more likely to develop suspicious screening results compared to female smokers. At the same time, patients with affected siblings are more likely to be later detected for suspicious nodules on low-dose CT screening. For patients with certain clinic characteristics, we would suggest for more frequent CT screening in order to detect for malignant disease at earlier stage.

Table of Contents

Table of Contents

Chapter 1 Introduction 1

1.1 Lung cancer as public health concern 1

1.2 Screening among high risk population 1

1.3 Current scoring system for screening interpretation 2

1.4 Study aim 3

Chapter 2 Literature Review 3

2.1 Demographic Characteristics 3

2.2 Medical History 4

2.3 Smoking History 7

Chapter 3 Method 7

3.1 Data Source: National Lung Screening Trial (NLST) 7

3.2 Lung RADS and NLST 8

3.3 Statistical Analysis 8

Chapter 4 Result 10

Chapter 5 Discussion 14

Reference 16

Appendix 18

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