Lung cancer screening for head and neck survivors?
Source: www.medpagetoday.com Author: Mike Bassett, Staff Writer, MedPage Today Head and neck cancer survivors are at an especially high risk for second primary lung cancers, a secondary analysis of the National Lung Screening Trial (NLST) suggested. After adjustment for various factors including pack-years of smoking, lung cancer incidence among NLST participants with a history of head and neck cancer was more than doubled compared to those without such a history, at 2,080 versus 609 cases per 100,000 person-years (adjusted rate ratio [RR] 2.54, 95% CI 1.63-3.95), reported John D. Cramer, MD, of Karmanos Cancer Institute in Detroit, and colleagues. According to the findings in JAMA Otolaryngology-Head & Neck Surgery, a non-significant trend toward improved overall survival was observed among those with a history of head and neck cancer who underwent low-dose CT (LDCT) in the trial rather than chest radiography (HR 0.79, 95% CI 0.42-1.52). As was a trend toward better detection of secondary lung cancer detection in those assigned to LDCT (RR 1.55, 95% CI 0.59-3.63). "The wide CIs, presumably due to the small sample size and number of outcome events, prevent definitive conclusions," noted Cramer and colleagues. Still, they argued, "these results support routine annual low-dose CT chest screening for lung cancer in HNC [head and neck cancer] survivors with prior significant tobacco use who are fit enough to undergo treatment with curative intent." In a commentary accompanying the study, Sean T. Massa, MD, of Louis University Hospital in St. Louis, and colleagues, also noted the small sample [...]