Prevalence of Benign Disease Diagnosis After Lung Surgery Varied Widely by State

• Prevalence of benign lung disease ranged from 1.2 percent in Vermont to 25 percent in Hawaii.
• 2.1 percent of patients with a benign diagnosis died in the hospital after surgery.
• Benefits of lung cancer screening may differ widely by state.

WASHINGTON, D.C. — Benign disease diagnosis rates after surgery for suspected lung cancer varied widely by state, and the reasons for these variations could inform health policy and clinical guidelines for lung cancer screening, according to a researcher who presented the data at the AACR Annual Meeting 2013, held in Washington, D.C., April 6-10.

“Given the results of the National Lung Screening Trial (NLST), which demonstrated that low-dose computed tomography (CT) reduces lung cancer mortality, and the support for screening healthy, high-risk individuals with low-dose CT by clinical and patient advocacy groups, we will likely see screening for lung cancer in our near future,” said Stephen A. Deppen, a doctoral candidate in epidemiology and database analyst at Vanderbilt University in Nashville, Tenn.

Data from NLST revealed that low-dose CT screening led to a 20 percent reduction in lung cancer-related mortality compared with chest X-ray; however, 96 percent of the positive screening results were false positives and 24 percent of follow-up lung resections were negative for lung cancer.

“It was not known whether the prevalence of benign disease diagnosis after lung resection for suspected lung cancer is uniform across the United States,” said Deppen. “If prevalence differs by state or region of the country, then a national lung cancer screening program may have varying results.”

He and his colleagues, therefore, set out to determine the prevalence of benign disease diagnosis rates by state.

Using the Medicare Provider Analysis and Review (MedPAR) Hospital National Limited Data Set from 2009, Deppen and colleagues evaluated medical data from 25,362 patients who underwent lung surgery for known or suspected lung cancer.

They found that 2,312 patients (9.1 percent) had a benign disease diagnosis after surgery. About 2.3 percent of all patients died in the hospital after the procedure. For those who were found not to have lung cancer, the mortality rate was 2.1 percent.

In addition, there was a wide variation among states in the prevalence of benign disease diagnosis, from 1.2 percent in Vermont to 25 percent in Hawaii.

“States with a higher rate of false positives and higher benign disease prevalence may observe poorer performance of a screening program for lung cancer,” Deppen said. “The benefit of screening for lung cancer is finding early-stage disease and reducing mortality from lung cancer. Lung surgery is major surgery and has a much higher risk for death and complications compared with diagnostic operations for other cancers, such as breast and prostate cancer. So, more surgeries for benign disease will result in more deaths and harm from the diagnostic process and will reduce the benefit that was observed in the original NLST.”

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About the American Association for Cancer Research
Founded in 1907, the American Association for Cancer Research (AACR) is the world’s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 17,000 attendees. In addition, the AACR publishes eight peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer. For more information about the AACR, visit www.AACR.org.

Media Contact:
Jeremy Moore
(215) 446-7109
Jeremy.Moore@aacr.org
In Washington, D.C.,
April 6-10, 2013:
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