PT  - JOURNAL ARTICLE
AU  - Niels-Chr. G. Hansen
TI  - False alarms: Negative invasive procedures and negative additional imaging after the introduction of a CT-based follow-up program in lung cancer patients treated with curative intent
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P353
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P353.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P353.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - The chance of a second curative treatment against recurrent lung cancer has increased 3-fold after the introduction from mid-2010 of the national post-therapy follow-up program in the county of Funen (484,500 inhabitants). The program recommends a contrast enhanced CT of thorax and upper abdomen every 3 months for two years and then every 6 months for three years. A population based quality assurance analysis has been performed to study potential disadvantages of the program. All new lung cancer patients from Funen in the 4-year period from July 1, 2008 were identified in the Danish Lung Cancer Registry and for those treated with curative intent the relevant data were extracted from hospital records in February 2014. After exclusion of patients, who died after surgery or had a relapse during therapy, 434 patients were included: 200 from the two years prior to the introduction of the follow-up program (group A) and 234 from the two years after (group B). No signs of over diagnosis have been found: The cumulated risk of recurrence has reached a “plateau” at 57% in both groups with a median time to recurrence = 35.2 months (group A) vs. 24.7 months (group B). A complete comparison of the first two years of follow-up for both groups will be possible in August 2014, but until February 2014 the fraction of patients having had at least one negative invasive diagnostic procedure during the first two years of follow-up has increased from 9.5% (group A) to 14.6% (group B) (p = 0.129, Fisher's Exact test). The use of PET-CT has increased more than 3-fold after the introduction of the CT-based follow-up.