Description
- Abstract:
- Background & Aims Significant Incidental Findings (SIFs) are widely reported in patients undergoing Low-dose CT (LDCT) lung screenings. Using data from the National Lung Screening Trial (NLST), we aim to identify occupational and medical conditions that may be associated with the detection of a SIF either with or without lung cancer at screening. Methods We analyzed data from the National Lung Screening Trial (NLST) which screened 53,452 participants accrued at 33 U.S. health centers. Participants were aged 55-74 at study entry, all current or former smokers who quit within the past 15 years. Participants were categorized based on whether they ever had a Significant Incidental Finding (SIF) and/or findings suspicious for Lung Cancer (POS) detected at screening during the National Lung Screening Trial, leading to 4 distinct outcome categories of ever POS only, ever SIF only, ever both POS/SIF, and always NEG. We used multinomial logistic regression to determine the covariate-adjusted association of occupational, medical condition, and smoking-related risk factors on NLST screening results for POS, POS/SIF, SIF, and NEG. Exposures of interest included pack years, years since quitting, cohabitation with smokers, coworking with smokers, comorbidity history, history of high-risk employment, and disease history. Confounding variables adjusted for included age, gender, race/ethnicity, education, and BMI. Results No evidence was found of an increased association between occupational exposures and POS/SIF or SIF screening outcome. The exception was occupational history of cotton jute processing (OR 0.497, p=0.03) which was found to be inversely associated with POS/SIF screening outcome. The odds of POS/SIF screening outcome increased by 0.3% (OR 1.003, p=0.006) for each additional pack year smoked, and increased by 2.2% (OR 1.02, p<0.001) for each year older a participant was when they stopped smoking. Conclusion Amongst the NLST screening population, occupational exposures did not appear to increase the likelihood of SIF detection during lung screening.
- Notes:
- Thesis (M. P. H.)--Brown University, 2025
Citation
Xi, Kevin,
"Assessing Risk Factors Associated with Incidental Findings in Low-Dose CT Lung Cancer Screenings"
(2025).
Epidemiology Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:w6gctbfm/
