Incidental diagnosis of lung cancer on chest CT scan performed for suspected or documented COVID-19 infection

• Published in: Respiratory medicine and research Vol. 85; p. 101084
• Main Authors: Wang, Pascal, Martel, Patricia, Hajjam, Mostafa El, Grimaldi, Lamiae, Giroux Leprieur, Etienne
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-06-2024
• Subjects: Aged; Aged, 80 and over; COVID - 19; COVID-19 - diagnostic imaging; COVID-19 - epidemiology; Female; Humans; Incidence; Incidental; Incidental Findings; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - epidemiology; Male; Middle Aged; Prospective Studies; SARS-CoV 2; Screening; Tomography, X-Ray Computed; Screening; COVID - 19; SARS-CoV 2; Lung cancer; Incidental
• ISSN: 2590-0412; 2590-0412
• DOI: 10.1016/j.resmer.2024.101084

Recent studies have shown a benefit of chest computed tomography (CT scan) in lung cancer screening. The COVID-19 pandemic has led to many chest CT scan performed on a large population. The objective of this study was to describe the incidence and characteristics of lung cancer detected on chest CT scan, outside the framework of a clinical trial, for a suspected or documented COVID-19 infection.
We conducted a multicenter study, carried out from the analysis of data from the prospective COVID-19 database of the Clinical Data Warehouse of the Greater Paris University Hospitals (AP-HP). We identified the patients who had been diagnosed with a lung cancer, due to a chest CT scan done for a suspected or confirmed COVID-19 infection. The study period was limited to the first two epidemic lockdowns: (03/01/20 - 05/31/20) and (10/10/20 - 11/30/20).
Over the study period, 24 390 patients had at least one chest CT scan. Among them, 72 lung cancer diagnoses were made (incidence 0.30 %; median age 67.4 years old, 50.0 % current smokers, 55.6 % adenocarcinoma). Half of the lung cancer patients (n = 36) did not meet the National Lung Screening Trial inclusion criteria. Twenty-six patients (36.1 %) were diagnosed at an early stage, 25 (34.7 %) of whom received radical curative treatment. Twenty-six patients died during the follow-up (36.1 %) but none in early stages. The median overall survival in lung cancer patients was 693 days [532 – NA].
A large-scale chest CT scan strategy for suspected or documented COVID-19 infection has allowed a significant proportion of early-stage lung cancer diagnosis, all of which have benefited from curative treatment.