BMJ Open Respiratory Research (Nov 2023)
Prevalence and clinical characteristics of non-malignant CT detected incidental findings in the SUMMIT lung cancer screening cohort
- ,
- Anthony Edey,
- Neal Navani,
- Andrew W Creamer,
- Kitty Chan,
- Graham Robinson,
- Janine Zylstra,
- Paul Robinson,
- Laura Green,
- Anand Devaraj,
- Jane Rowlands,
- Allan Hackshaw,
- Carolyn Horst,
- Arjun Nair,
- Sam M Janes,
- Kate Davies,
- Jeannie Eng,
- Mamta Ruparel,
- Samantha L Quaife,
- Jennifer L Dickson,
- Magali Taylor,
- Angshu Bhowmik,
- Karen Sennett,
- Samantha Quaife,
- Samuel Janes,
- Hasti Robbie,
- Joseph Jacob,
- Laura Farrelly,
- Sophie Tisi,
- Andrew Creamer,
- Helen Hall,
- Samanjit Hare,
- Jon Teague,
- Thea Buchan,
- Stephen Ellis,
- Thomas Callender,
- Rachael Sarpong,
- John McCabe,
- Zaheer Mangera,
- Ethaar El-Emir,
- Terry O'Shaughnessy,
- Nick Screaton,
- Priyam Verghese,
- William M Ricketts,
- Anne-Marie Mullin,
- Vicky Bowyer,
- Kylie Gyertson,
- Fanta Bojang,
- Claire Levermore,
- Ruth Prendecki,
- Amyn Bhamani,
- Malavika Suresh,
- Judy Airebamen,
- Alice Cotton,
- Kaylene Phua,
- Elodie Murali,
- Simranjit Mehta,
- Karen Parry-Billings,
- Columbus Ife,
- April Neville,
- Zahra Hanif,
- Helen Kiconco,
- Ricardo McEwen,
- Dominique Arancon,
- Nicholas Beech,
- Derya Ovayolu,
- Christine Hosein,
- Sylvia Patricia Enes,
- Qin April Neville,
- Aashna Samson,
- Urja Patel,
- Fahmida Hoque,
- Hina Pervez,
- Sofia Nnorom,
- Moksud Miah,
- Julian McKee,
- Mark Clark,
- Anant Patel,
- Sara Lock,
- Rajesh Banka,
- Ugo Ekeowa,
- Charlotte Cash,
- Tunku Aziz,
- Alberto Villanueva,
- Elena Stefan,
- Charlie Sayer,
- Navinah Nundlall,
- Lyndsey Gallagher,
- Andrew Crossingham,
- Tanita Limani,
- Kate Gowers,
- James Rusius,
- Jennifer Dickson,
- Anne-Marie Hacker,
- Jonathon Teague,
- Andrew Perugia TaniaAnastasiadis
Affiliations
- Anthony Edey
- 9 North Bristol NHS Trust, Westbury on Trym, UK
- Neal Navani
- 2 Respiratory Medicine, University College London, London, UK
- Andrew W Creamer
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Kitty Chan
- Graham Robinson
- Janine Zylstra
- Paul Robinson
- Trauma and Orthopaedics, Peterborough City Hospital, Peterborough, UK
- Laura Green
- Anand Devaraj
- Department of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- Jane Rowlands
- Allan Hackshaw
- Cancer Research UK and UCL Cancer Trials Centre, London, UK
- Carolyn Horst
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Arjun Nair
- University College London Hospitals NHS Foundation Trust, London, UK
- Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Kate Davies
- 1UCL Cancer Institute, Pre-Cancer Immunology Laboratory, London, UK
- Jeannie Eng
- Stroke Research Centre, Institute of Neurology, University College London, London, UK
- Mamta Ruparel
- Respiratory and Critical Care Medicine, National University Hospital, Singapore
- Samantha L Quaife
- Jennifer L Dickson
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Magali Taylor
- Angshu Bhowmik
- Karen Sennett
- Samantha Quaife
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Samuel Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Hasti Robbie
- Joseph Jacob
- 1 Department of Respiratory Medicine, University College London, London, UK
- Laura Farrelly
- Cancer Research UK and UCL Cancer Trials Centre, London, UK
- Sophie Tisi
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Andrew Creamer
- Helen Hall
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Samanjit Hare
- Jon Teague
- Thea Buchan
- Stephen Ellis
- Thomas Callender
- Rachael Sarpong
- John McCabe
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Zaheer Mangera
- Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, UK
- Ethaar El-Emir
- Terry O'Shaughnessy
- Nick Screaton
- Priyam Verghese
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- William M Ricketts
- Anne-Marie Mullin
- Cancer Research UK and UCL Cancer Trials Centre, London, UK
- Vicky Bowyer
- University College London Hospitals NHS Foundation Trust, London, UK
- Kylie Gyertson
- University College London Hospitals NHS Foundation Trust, London, UK
- Fanta Bojang
- Claire Levermore
- University College London Hospitals NHS Foundation Trust, London, UK
- Ruth Prendecki
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Amyn Bhamani
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Malavika Suresh
- Judy Airebamen
- Alice Cotton
- Kaylene Phua
- Elodie Murali
- Simranjit Mehta
- Karen Parry-Billings
- Columbus Ife
- April Neville
- Zahra Hanif
- Helen Kiconco
- Ricardo McEwen
- Dominique Arancon
- Nicholas Beech
- Derya Ovayolu
- Christine Hosein
- Sylvia Patricia Enes
- Qin April Neville
- Aashna Samson
- Urja Patel
- Fahmida Hoque
- Hina Pervez
- Sofia Nnorom
- Moksud Miah
- Julian McKee
- Mark Clark
- Anant Patel
- Sara Lock
- Rajesh Banka
- Ugo Ekeowa
- Charlotte Cash
- Tunku Aziz
- Alberto Villanueva
- Elena Stefan
- Charlie Sayer
- Navinah Nundlall
- Lyndsey Gallagher
- Andrew Crossingham
- Tanita Limani
- Kate Gowers
- 1UCL Cancer Institute, Pre-Cancer Immunology Laboratory, London, UK
- James Rusius
- Jennifer Dickson
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Anne-Marie Hacker
- Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK
- Jonathon Teague
- Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK
- Andrew Perugia TaniaAnastasiadis
- DOI
- https://doi.org/10.1136/bmjresp-2023-001664
- Journal volume & issue
-
Vol. 10,
no. 1
Abstract
Background Pulmonary and extrapulmonary incidental findings are frequently identified on CT scans performed for lung cancer screening. Uncertainty regarding their clinical significance and how and when such findings should be reported back to clinicians and participants persists. We examined the prevalence of non-malignant incidental findings within a lung cancer screening cohort and investigated the morbidity and relevant risk factors associated with incidental findings. We quantified the primary and secondary care referrals generated by our protocol.Methods The SUMMIT study (NCT03934866) is a prospective observational cohort study to examine the performance of delivering a low-dose CT (LDCT) screening service to a high-risk population. Spirometry, blood pressure, height/weight and respiratory history were assessed as part of a Lung Health Check. Individuals at high risk of lung cancer were offered an LDCT and returned for two further annual visits. This analysis is a prospective evaluation of the standardised reporting and management protocol for incidental findings developed for the study on the baseline LDCT.Results In 11 115 participants included in this analysis, the most common incidental findings were coronary artery calcification (64.2%) and emphysema (33.4%). From our protocolised management approach, the number of participants requiring review for clinically relevant findings in primary care was 1 in 20, and the number potentially requiring review in secondary care was 1 in 25.Conclusions Incidental findings are common in lung cancer screening and can be associated with reported symptoms and comorbidities. A standardised reporting protocol allows systematic assessment and standardises onward management.
