[MP Test] Lung cancer screening tied to reduced mortality

In an observational study conducted in Poland, individuals who participated in a low-dose computed tomography (LDCT) lung cancer screening programme had a reduction in all-cause mortality compared with a matched control group extracted from a general Polish cohort.

“We did a case-control study with propensity-score matching with at least 10 years of follow-up … to assess whether participation in an LDCT lung cancer screening project reduces overall mortality,” said Dr Robert Dziedzic from the Medical University of Gdansk, Poland, during his presentation at ELCC 2024.

For this study, Dziedzic and his team included 7,281 participants from the Pilot Pomeranian Lung Cancer Screening Programme who underwent LDCT lung cancer screening between 2009 and 2011. Participants were aged 50–75 years. The group of screened participants was matched with a control group (n=36,405) from a general Polish population of 9.8 million individuals. [ELCC 2024, abstract 176MO]

Multivariate analysis revealed that participation in the LDCT lung cancer screening programme had a beneficial effect on long-term survival (hazard ratio [HR], 0.653).

Ten-year survival was almost 6 percent better in the LDCT screening programme group than in the control group (86.9 percent vs 81.3 percent; p<0.001), Dziedzic added.

Cancer-related factors that negatively impact survival were lung cancer diagnosis (HR, 5.141) and other neoplasms such as colorectal cancer (HR, 2.166) and breast cancer (HR, 1.837). Non-cancer factors negatively affecting survival were cerebral infarction (HR, 2.451), heart failure (HR, 2.061), chronic kidney disease (2.044), chronic obstructive pulmonary disease (HR, 1.766), atherosclerosis (HR, 1.503), and diabetes (HR, 1.471).

Hitting many birds with one stone

“[Anatomically, LDCT] covers from the lower neck to the upper abdomen; hence, a lot of structures can be seen,” pointed out discussant Dr Jelena Spasic from the Institute for Oncology and Radiology of Serbia, Belgrade, Serbia, during her presentation at ELCC 2024. This enables LDCTs to ‘see’ beyond lung cancer, she said.

“Detection of other pathological changes during LDCT screening leads to treatment … [Subsequently, this could contribute to the] reduction in all-cause mortality,” Spasic explained. She added that this could probably be the reason why those who have undergone the screening programme live longer than those who have not.

“Realistically, screening programmes can reduce all-cause mortality by 1–3 percent … [While] it may not be statistically significant, from a public health perspective, this is highly clinically relevant. Therefore, all-cause mortality should be monitored,” Spasic said.

“[As such,] implementing lung cancer screening should be prioritized in all systems … If we can collect data on comorbidities influencing survival, we can put the impact of a lung cancer screening programme on survival in a broader context,” she continued.

“[With] lung cancer screening, we are basically targeting many birds with one low-dose stone,” Spasic said.