Title Information
Title
Assessing Risk Factors Associated with Incidental Findings in Low-Dose CT Lung Cancer Screenings
Type of Resource (primo)
dissertations
Name: Personal
Name Part
Xi, Kevin
Role
Role Term: Text
creator
Name: Personal
Name Part
Gareen, Ilana
Role
Role Term: Text
Advisor
Name: Personal
Name Part
Joyce, Nina
Role
Role Term: Text
Reader
Name: Corporate
Name Part
Brown University. Department of Epidemiology
Role
Role Term: Text
sponsor
Origin Information
Copyright Date
2025
Physical Description
Extent
2, 25 p.
digitalOrigin
born digital
Note: thesis
Thesis (M. P. H.)--Brown University, 2025
Genre (aat)
theses
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.
Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00914091")
Topic
Epidemiology
Subject
Topic
significant incidental findings
Subject
Topic
multinomial model
Language
Language Term (ISO639-2B)
English
Record Information
Record Content Source (marcorg)
RPB
Record Creation Date (encoding="iso8601")
20250707