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- RE: Commentary for “Results of Lung Cancer Screening in the Community”
The study “Results of Lung Cancer Screening in the Community” was conducted to address concerns regarding the generalizability of the National Lung Screening Trial (NLST) findings to community settings. The previous NLST study reported a 20% decrease in lung cancer mortality using lung cancer screening (LCS) in high risk patient populations. However, the NLST study utilized expert medical centers in the detection and treatment of lung cancer. This paper seeks to evaluate LCS in non-university, tertiary care, community settings.
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Patients were recruited from a wide array of settings including non-university tertiary clinics, community medical centers, and free-standing imaging centers. Primary care physicians referred patients for screening, and shared decision making preceding a patient receiving a low-dose CT scan. All CT scans were categorized into 4 categories, with category 1-3 being negative, benign, or probably benign respectively. Category 4 scans, which were suspicious for lung cancer, were reviewed by a multidisciplinary thoracic disease conference. The conference included physicians from a variety of specialties including medical oncology, thoracic surgery, radiation oncology, and pulmonology. The group agreed that having a dedicated group of highly specialized physicians to review scans would be difficult to achieve in community settings, especially those with limited resources. Furthermore, patients with suspected lung cancer were scheduled to follow-up wi...Competing Interests: None declared.