Five-Year Outcome of Lung Cancer Detection in Patients With and Without Airflow Obstruction in a Primary Care Outpatient Practice

IntroductionWe have previously published the outcome of a community-based lung cancer screening program. We now report on the 5-year follow-up of this study and include both patients with and without airflow obstruction.Materials and MethodsOne thousand two hundred fifty-six patients completed questionnaires in the office of their primary care physicians, and 430 of this group were assessed to be at high risk for lung cancer. These patients then underwent spirometry, and 88 of 126 patients with airflow obstruction consented to lung cancer screening test.Testing MethodsComplete screening testing included spirometry, two-view chest radiograph, chest CT scan, and sputum cytology examinations.ResultsEight lung cancers were found in the high-risk group with airflow obstruction. No more cancers were found in the tested group in the 5 years since the earlier report. Ten cancers were found in the 304 patients with normal airflow, not previously reported. In all, 18 lung cancers were found in 430 patients deemed at risk by a simple one-page questionnaire (4.2%).ConclusionsA questionnaire, self-administered in a primary care office setting, helps identify patients at high risk of lung cancer. If upcoming results of randomized controlled trials show a benefit of lung screening, this tool could be of help to select patients for screening.