Early Detection of Lung Cancer: A Statement from an Expert Panel of the Swiss University Hospitals on Lung Cancer Screening

Frauenfelder, Thomas; Puhan, Milo A.; Lazor, Romain; Garnier, Christophe von; Bremerich, Jens; Niemann, Tilo; Christe, Andreas; Montet, Xavier; Gautschi, Oliver; Weder, Walter; Kohler, Malcom

doi:10.1159/000357049

Cited by 29 publications

(29 citation statements)

References 68 publications

(110 reference statements)

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“…41 42 Screening trials are ongoing in many parts of the world to further evaluate the benefits, harms, and cost-effectiveness of lung cancer screening. 43,44 Epidemiology In recent decades, the predominant NSCLC histologic type has shifted from squamous to adenocarcinoma, especially in developed countries. 45 This may be due in part to the shift to low-tar filter cigarettes, in which small particles are inhaled more deeply into the periphery of…”

Section: Etiologymentioning

confidence: 99%

Clinicopathologic Features of Advanced Squamous NSCLC

Socinski

Obasaju

Gandara

et al. 2016

Journal of Thoracic Oncology

126

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Lung cancer remains the leading cause of cancer-related death worldwide. NSCLC accounts for more than 85% of all lung cancers, and the prognosis for advanced-stage disease is typically poor. In recent years, the importance of histologic subtypes of NSCLC has been recognized, and the distinction between squamous and other NSCLC histologic subtypes is now critical to patient management. Squamous cell lung cancer (sqCLC) represents approximately 25% to 30% of NSCLC. The prognosis for patients with advanced NSCLC is poorer for those with sqCLC than for those with adenocarcinoma. This is partly due to a number of clinical characteristics that distinguish sqCLC from other NSCLC histologic subtypes, such as smoking history, comorbid diseases, age, and molecular profile. Together, these factors make sqCLC an especially challenging disease to manage. Herein, we review some of the key clinicopathologic features of sqCLC. Understanding these features to optimally address many of the unique therapeutic challenges of this disease is likely to be central to ultimately improving outcomes for patients with squamous NSCLC.

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Section: Etiologymentioning

confidence: 99%

Clinicopathologic Features of Advanced Squamous NSCLC

Socinski

Obasaju

Gandara

et al. 2016

Journal of Thoracic Oncology

126

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“…Consequently, several organizations have decided not to implement screening programs. Where screening programs have been implemented, they are focused specifically on the population at high risk (17).…”

Section: Incidental Findings On Spect/ct Mpimentioning

confidence: 99%

“…Almost all patients who are told they have a pulmonary nodule assume they have cancer (16). Just raising the possibility of cancer can be threatening (17) and can lead to distress until, and possibly beyond, definitive diagnosis (18).…”

Section: Psychologic Effectsmentioning

confidence: 99%

The Clinical Dilemma of Incidental Findings on the Low-Resolution CT Images from SPECT/CT MPI Studies

Coward

Nightingale

Hogg

2016

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than September 2019. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.Incidental findings are common in medical imaging. There is a particularly high prevalence of incidental findings within the thorax, the most frequent being pulmonary nodules. Although pulmonary nodules have the potential to be malignant, most are benign, resulting in a high number of false-positive findings. Low-resolution CT images produced for attenuation correction of SPECT images are essentially a by-product of the imaging process. The high number of false-positive incidental findings detected on these attenuation-correction images causes a reporting dilemma. Early detection of cancer can be beneficial, but falsepositive findings and overdiagnosis can be detrimental to the patient. Attenuation-correction CT images are not of diagnostic quality, and further diagnostic tests are usually necessary for a definitive diagnosis to be reached. Given the high number of falsepositive findings, the psychologic effect on the patient should be considered. This review recommends caution when the findings on attenuation-correction CT images are routinely reported. Medi cal imaging uses a range of modalities that yield both anatomic and functional information (1). Visual correlation of images acquired using separate modalities can provide more information than images from a single modality alone, though there is an inevitable risk of misregistration between images that have been acquired during different imaging sessions. The development of hybrid imaging has led to the integration of two modalities in one machine, allowing coregistration of images that have been acquired in a single session (1,2). This allows direct correlation of anatomic and functional information, increasing sensitivity and specificity while adding clarity to indeterminate cases (3). SPECT/CT offers an excellent example of hybrid imaging, combining the functional ability of SPECT with the anatomic ability of CT.The strength of SPECT lies in gaining pathophysiologic detail in a minimally invasive way (4). Pathologic processes can be identified by uptake of radiopharmaceuticals, but the precise location is often difficult to ascertain because of low image resolution and a lack of anatomic landmarks. Moreover, uptake on some scans is often nonspecific, revealing abnormalities but not their specific cause. CT can provide a useful means of localization, also enabl...

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“…Resources may be better used to prevent smoking and to encourage quitting [10][11][12][13]. Similarly, prostate cancer screening using the prostate-specific antigen (PSA) test may have a very small benefit in men younger than 70 years, but it can also lead to adverse outcomes, such as unnecessary procedures.…”

Section: Cancer Screening and Preventionmentioning

confidence: 99%