TY - JOUR T1 - Improving NLST criteria for lung cancer screening JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P352 AU - Pablo Sanchez AU - Juan Pablo De-Torres AU - David O. Wilson AU - Joel Weissfeld AU - Arantzazu Campo AU - Ana Belen Alcaide AU - Javier Zulueta Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P352.abstract N2 - Lung cancer (LC) screening with low dose CT (LDCT) is now recommended by several guidelines. Most of the recommendations rely on the National Lung Screening Trial (NLST). We analyzed the Pamplona Lung Cancer Screening Program (P-ELCAP) and the Pittsburgh Lung Screening Study (PLuSS) in order to evaluate NLST criteria performance.The P-ELCAP (Spain) and PLuSS (USA), are both LC screening studies that use LDCT (Chest 2007;132:1932–8, AJRCCM 2008;178:738–44). Each has different selection criteria, much broader than NLST. We applied NLST entry criteria (55-74y, ≥30pack-y, ≤15y tobacco cessation) and compared diagnostic yields. Incidence density (ID) per 1000 person-years and lung cancer detection rates (LCDR) were calculated for each scenario. The addition of COPD and emphysema as entry criteria was also evaluated.Almost one third of P-ELCAP (737/2302) participants and 59% of PLuSS (2161/3638) met NLST criteria. Lung cancer ID and LCDR were higher for the NLST subgroups in both cohorts, although several LC cases were missed (40% and 25% of the original cancers, respectively). In comparison to NLST criteria, adding COPD and emphysema to the original entry criteria improved the absolute number of LC diagnoses, the ID, the LCDR, and the number needed to be screened to detect one LC (Table 1 and 2).LC screening programs based solely in NLST criteria might result in several undetected cases. The presence of COPD and emphysema appear to improve LC detection rates. ER -