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Published December 3, 2020 | Version v.1
Journal article Open

Lung Cancer Screening Considerations During Respiratory Infection Outbreaks, Epidemics or Pandemics: An International Association for the Study of Lung Cancer Early Detection and Screening Committee Report

Creators

  • 1. Division of Respiratory Medicine and Thoracic Oncology, Department of Medicine V, Ludwig-Maximilian-University of Munich, Thoracic Oncology Centre Munich, German Centre for Lung Research (DZL CPC-M), Munich, Germany
  • 2. Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
  • 3. c Department of Radiology, National Korányi Institute for Pulmonology, Budapest, Hungary
  • 4. Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
  • 5. Roy Castle Lung Cancer Research Programme, The University of Liverpool, Department of Molecular and Clinical Cancer Medicine, Liverpool, United Kingdom
  • 6. Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China
  • 7. Division of Cardiothoracic Radiology, Department of Radiology, University of Michigan Medical School/Michigan Medicine, Ann Arbor, Michigan ; Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School/Michigan Medicine, Ann Arbor, Michigan
  • 8. Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
  • 9. Department of Pulmonary, Critical Care, and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
  • 10. Hospital Cárdio Pulmonar da Bahia, Hospital Israelita Albert Einstein, São Paulo, Brazil
  • 11. Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Italy
  • 12. mThe International Association for the Study of Lung Cancer, Denver, Colorado
  • 13. Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
  • 14. Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine, New York, New York
  • 15. Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seoul, South Korea
  • 16. Prevention and Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
  • 17. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
  • 18. Department of Integrative Oncology, BC Cancer and Department of Medicine, University of British Columbia, Vancouver, Canada

Description

After the results of two large, randomized trials, the global implementation of lung cancer screening is of utmost importance. However, coronavirus disease 2019 infections occurring at heightened levels during the current global pandemic and also other respiratory infections can influence scan interpretation and screening safety and uptake. Several respiratory infections can lead to lesions that mimic malignant nodules and other imaging changes suggesting malignancy, leading to an increased level of follow-up procedures or even invasive diagnostic procedures. In periods of increased rates of respiratory infections from severe acute respiratory syndrome coronavirus 2 and others, there is also a risk of transmission of these infections to the health care providers, the screenees, and patients. This became evident with the severe acute respiratory syndrome coronavirus 2 pandemic that led to a temporary global stoppage of lung cancer and other cancer screening programs. Data on the optimal management of these situations are not available. The pandemic is still ongoing and further periods of increased respiratory infections will come, in which practical guidance would be helpful. The aims of this report were: (1) to summarize the data available for possible false positive results owing to respiratory infections; (2) to evaluate the safety concerns for screening during times of increased respiratory infections, especially during a regional outbreak or an epidemic or pandemic event; (3) to provide guidance on these situations; and (4) to stimulate research and discussions about these scenarios.

Notes

This work was funded by the International Association for the Study of Lung Cancer, which granted organizational support to the Early Detection and Screening Committee and also supported the development of this article. This research was, in addition, supported by the American College of Radiology's National Radiology Data Registry (NRDR). The views expressed in this article represent those of the authors and do not necessarily represent the official views of the NRDR or the American College of Radiology. The authors also thank the American College of Radiology staff for their assistance in the preparation of the Lung Cancer Screening Registry data and the LCS Registry Steering Committee for their guidance and input in this analysis. Finally, the authors thank Dr. Jose Cervera, Department of Radiology, Instituto Valenciano de Oncologia, Valencia for the information coming from Spain.

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