Zeinstra, Hiske (2024) High frequency of incidental lung cancer diagnosis in Frisia. thesis, Medicine.
Full text available on request.Abstract
Background: In the Netherlands, lung cancer (LC) remains the deadliest malignancy. Early diagnosis improves survival, but LC is usually discovered at an advanced stage due to the low symptom burden in the early stages. An incidental diagnosis may occur when patients are investigated for symptoms unrelated to LC. This study assessed the incidence of incidental diagnoses of LC preceding the start of LC screening. Methods: This real-world observational study included patients diagnosed with LC in 2021 across all four Frisian hospitals. Data from the Netherlands Comprehensive Cancer Organization was supplemented with information from medical records. Cases were classified as incidental if no LC-related symptoms were present at diagnosis. Results: 523 patients were included in the study. An incidental diagnosis was noted in 149 (28.5%) patients, rising to 84.6% in stage I disease. More patients were ex-smokers (p=.004) and of older age (p=.003). 109 (73.2%) patients with incidental diagnoses were referred by other clinical specialties; motives and detection methods were highly variable. 78 (52.3%) of all incidental cases were classified as incidental pulmonary nodules (IPN), and 27/78 were related to other cancers. Only 19/54 (35.2%) of incidental cases met screening criteria. The 2-year survival rate was significantly higher for incidental cases (65.7%) compared to symptomatic cases (22.2%). Survival rates were similar for patients of all disease stages (p=.87). Conclusion: Incidental LC diagnosis is common, especially in stage I disease, and often occurs in individuals ineligible for screening. This highlights the potential benefit of broader screening criteria or alternative early detection strategies.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Gijtenbeek, Drs. R.G.P. |
| Faculty: | Medical Sciences |
| Date Deposited: | 11 Feb 2025 12:07 |
| Last Modified: | 11 Feb 2025 12:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3804 |
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