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Annals of Internal Medicine tip sheet for Feb. 19, 2013
Date:2/18/2013

p>Note: For an embargoed PDF, please contact Megan Hanks or Angela Collom. To speak with the author, please contact Anne Berghoefer at anne.berghoefer@charite.de. A link to the summary for patients is free to the public http://www.annals.org/article.aspx?doi=10.7326/0003-4819-158-4-201302190-00001. The link will be live at 5:00 p.m. on February 18.


2. Researchers Assess the Benefits and Risks of Redefining a Positive CT Result for Lung Cancer

Using a threshold of 7 or 8 mm to define a positive lung cancer result in a baseline round of computed tomography (CT) could decrease false positive screening results. However, prospective research is needed to determine whether increasing the threshold may delay diagnosis of cancer in some patients. In CT screening for lung cancer, the positive result of the initial low-dose CT indicates whether further diagnostic work-up is needed before the first scheduled repeated screening. A definition that is too inclusive may cause excessive diagnostic work-up and unnecessary treatment, while a definition that is too restrictive may delay diagnosis. In the past decade, the frequency of identifying a noncalcified nodule (NCN) of any size on the initial baseline CT scan has almost tripled. This is mostly due to technological advances in CT scanners and the use of large computer monitors to display the CT images. Changing the size threshold for a positive screening could help reduce the harms associated with unnecessary, invasive work-up of false positive screening tests. Researchers reviewed medical records for a cohort of 21,136 patients who had a baseline CT performed between 2006 and 2010 to assess how using a more restrictive threshold in the baseline round of screening would affect the number of positive results and delayed diagnoses. Of th
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Contact: Megan Hanks
mhanks@acponline.org
215-351-2656
American College of Physicians
Source:Eurekalert

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