BMJ Open Respiratory Research (Jul 2023)
Prevalence and clinical characteristics of non-malignant CT detected incidental findings in the SUMMIT lung cancer screening cohort
- ,
- Anthony Edey,
- John R Hurst,
- 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
- John R Hurst
- UCL Respiratory, University College London, London, UK
- Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, 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
- University College London Hospitals NHS Foundation Trust, London, UK
- Laura Green
- NHS Blood & Transplant and Barts Health NHS Trust, London, UK
- Anand Devaraj
- 1 National Heart and Lung Institute, Imperial College, London, UK
- Jane Rowlands
- Allan Hackshaw
- UCL Cancer Institute, University College 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
- 1 Division of Population Medicine, Cardiff University, Cardiff, Cardiff, UK
- Jeannie Eng
- Stroke Research Centre, Institute of Neurology, University College London, London, UK
- Mamta Ruparel
- Samantha L Quaife
- 1 Queen Mary University of London, London, UK
- Jennifer L Dickson
- 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
- 2 Department of Radiology, Kings College Hospital, London, UK
- Joseph Jacob
- 3 Centre for Medical Image Computing, UCL, London, UK
- Laura Farrelly
- Cancer Research UK and UCL Cancer Trials Centre, University College London, London, UK
- Sophie Tisi
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Andrew Creamer
- 2 Brown University Library, Providence, Rhode Island, USA
- Helen Hall
- 2 James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
- Samanjit Hare
- Jon Teague
- Thea Buchan
- Stephen Ellis
- Thomas Callender
- public health registrar
- Rachael Sarpong
- John McCabe
- Zaheer Mangera
- Department of Respiratory Medicine, North Middlesex University Hospital NHS Trust, London, UK
- Ethaar El-Emir
- 2 Harefield Respiratory Research Group, Royal Brompton & Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, UK, London, UK
- 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
- Vicky Bowyer
- Department of Twin Research and Genetic Epidemiology, King`s College London, London, UK
- Kylie Gyertson
- University College London Hospitals NHS Foundation Trust, London, UK
- Fanta Bojang
- University College London Hospitals NHS Foundation Trust, London, UK
- Claire Levermore
- University College London Hospitals NHS Foundation Trust, London, UK
- Ruth Prendecki
- 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
- 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.
