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Early Detection of Primary Lung Cancer Using Low-Dose CT Screening and Risk of Brain Metastases

By: Joseph Fanelli
Posted: Thursday, October 7, 2021

According to a large population-based study presented in the Journal of Thoracic Oncology, using low-dose computed tomography (CT) screening for early detection of primary lung cancer may be associated with a lower risk of brain metastasis in recently diagnosed patients. Summer S. Han, PhD, of the Stanford University School of Medicine, California, and colleagues found that the reduction in risk may not be fully explained by stage shift or curative treatment of primary lung cancer.

“The reduction in brain metastasis risk may be because of a potentially different tumor biology of the tumors detected by low-dose CT screening that are less aggressive and slow growing, which needs to be confirmed by further investigation,” the authors concluded.

In this study, the authors used data from the National Lung Screening Trial to identify 1,502 patients who were diagnosed with primary lung cancer from 2002 to 2009 and had follow-up data for brain metastases. Cause-specific competing risk aggression was applied to evaluate an association between brain metastases risk and the mode of primary lung cancer detection (ie, low-dose CT screening vs. non–low-dose CT screening).

Of the patients analyzed, 41.4% had primary lung cancer detected through low-dose CT screening, compared with 58.6% whose cancer was detected by some other method such as chest radiography or incidental detection. Patients whose primary lung cancer was detected by low-dose CT screening had a significantly lower 3-year incidence of brain metastasis (6.5%) versus those with a different mode of detection (11.9%). The reduction in brain metastases risk, the authors noted, was also seen in subgroups of participants with early-stage primary lung cancer (hazard ratio = 0.47) and in those who had surgery (hazard ratio = 0.37).

Disclosure: For full disclosures of the study authors, visit jto.org.



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