The Incidental Diagnosis of Lung Cancer Through Chest Tomography During the COVID-19 Pandemic
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Original research article

The Incidental Diagnosis of Lung Cancer Through Chest Tomography During the COVID-19 Pandemic

J Oncol Sci 2023;9(3):152-157 DOI: 10.37047/jos.2023-98748
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Abstract

Objective: This study aims to determine the frequency of incidental lung cancers detected during chest computed tomography (CT) scans performed for guiding the diagnosis or treatment of coronavirus disease-2019 (COVID-19). Material and Methods: In this single- center retrospective study, the chest CT scans taken during the beginning of COVID-19 pneumonia (mostly pre-vaccination era) between April 2020 and December 2020 were examined. Patients who were younger than 18 years and those with a prior history of cancer were excluded. Moreover, the clinicopathological factors and radiologic findings of those patients with pulmonary nodule size on CT ≥3 mm or masses were recorded. Results: We assessed the CT scans of 2994 patients. A pulmonary nodule ≥3 mm or a mass was detected in 473 patients, while nine of them were diagnosed with lung cancer. The median age of lung cancer patients was 65 years (48-71 years). The most common subtype of lung cancer was adenocarcinoma (44.4%), followed by squamous cell carcinoma (33.3%) and small cell lung cancer (22.2%). Furthermore, all patients were diagnosed at the non-metastatic stage. Conclusion: Our study showed that early-stage lung cancers were detected incidentally on CT scans in suspected COVID-19 pneumonia patients. While the COVID-19 pandemic resulted in significant mortality worldwide, early diagnosis and treatment of these cases can save several lives.

Keywords: Cancer screening, COVID-19, incidence, incidental finding, lung cancer

References

1

Garg M, Prabhakar N, Bhalla AS, et al. Computed tomography chest in COVID-19: When & why? Indian J Med Res. 2021;153(1 & 2):86-92.

2

T.C. Sağlık Bakanlığı [İnternet]. © 2023 T.C. Sağlık Bakanlığı [Erişim tarihi: 19 Mart 2023]. Günlük COVID-19 aşı tablosu. Erişim linki:

3

World Health Organization [Internet]. ©2023 WHO [Cited: March 19, 2022]. WHO coronavirus (COVID-19) dashboard. Available from:

4

Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045. Erratum in: Euro Surveill. 2020;25(14): Erratum in: Euro Surveill. 2020;25(30): Erratum in: Euro Surveill. 2021;26(5):

5

Özkarafakılı MA, Özkurt H, Bardakçı Mİ, et al. Comparison of chest computed tomography findings of RT-PCR negative and RT-PCR positive cases in COVID-19 patients. Clin Imaging. Feb 2022;82:7-12.

6

Jacobs PC, Mali WP, Grobbee DE, van der Graaf Y. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;32(2):214-221.

7

National Cancer Institute [Internet]. [Cited: March 8, 2022]. Cancer Stat Facts: Common Cancer Sites. Available from:

8

Dinmohamed AG, Visser O, Verhoeven RHA, et al Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. Lancet Oncol. 2020;21(6):750-751. Erratum in: Lancet Oncol. 2020:

9

IQVIA [Internet]. ©2023 IQVIA. Shifts in healthcare demand, delivery and care during the COVID-19 era. 05.01.2023. Available from:

10

Sümbül A, Yalçin S, Özet A, et al. Turkish society of medical oncology covid-19 pandemic advisory board updated recommendations for medical oncologists: Included vaccination. Journal of Oncological Sciences. 2021;7(1):1-6.

11

American College of Radiology [Internet]. [Cited: ]. ACR Recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. 29.04.2022 Available from:

12

de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med. 2020;382(6):503-513.

13

Dündar İ, Özkaçmaz S, Durmaz F, et al. Detection of incidental findings on chest CT scans in patients with suspected Covid-19 pneumonia. Eastern Journal of Medicine. 2021;26(4):566-574.

14

Ronit A, Kristensen T, Klitbo DM, et al. Incidental lung cancers and positive computed tomography images in people living with HIV. AIDS. 2017;31(14):1973-1977.

15

Manser RL, Dodd M, Byrnes G, Irving LB, Campbell DA. Incidental lung cancers identified at coronial autopsy: implications for overdiagnosis of lung cancer by screening. Respir Med. 2005;99(4):501-507.

16

Aberle DR, DeMello S, Berg CD, et al; National Lung Screening Trial Research Team. Results of the two incidence screenings in the National Lung Screening Trial. N Engl J Med. 2013;369(10):920-931.

17

Field JK, Duffy SW, Baldwin DR, et al. UK lung cancer RCT pilot screening trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening. Thorax. 2016;71(2):161-170.

18

Travis WD, Brambilla E, Nicholson AG, et al; WHO Panel. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol. 2015;10(9):1243-1260.

19

T.C. Sağlık Bakanlığı [İnternet]. ©2017 Halk Sağlığı Genel Müdürlüğü [Erişim tarihi: 23 Şubat 2023]. 2017 yili türkiye kanser istatistikleri. Erişim linki:

20

Jonas DE, Reuland DS, Reddy SM, et al. Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US preventive services task force. JAMA. 2021;325(10):971-987.

21

Hoffman RM, Atallah RP, Struble RD, Badgett RG. Lung cancer screening with low-dose CT: a meta-analysis. J Gen Intern Med. 2020;35(10):3015-3025.

22

Quadrelli S, Lyons G, Colt H, Chimondeguy D, Buero A. Clinical characteristics and prognosis of incidentally detected lung cancers. Int J Surg Oncol. 2015;2015:287604.

23

Yekedüz E, Karcıoğlu AM, Utkan G, Ürün Y. A clinical dilemma amid COVID-19 pandemic: missed or encountered diagnosis of cancer? Future Oncol. 2020;16(25):1879-1881.

24

Goncalves S, Fong PC, Blokhina M. Artificial intelligence for early diagnosis of lung cancer through incidental nodule detection in low- and middle-income countries-acceleration during the COVID-19 pandemic but here to stay. Am J Cancer Res. 2022;12(1):1-16.

25

LeMense GP, Waller EA, Campbell C, Bowen T. Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program. BMC Pulm Med. 2020;20(1):115.

26

Kocher F, Lunger F, Seeber A, et al. Incidental diagnosis of asymptomatic non-small-cell lung cancer: a registry-based analysis. Clin Lung Cancer. 2016;17(1):62-67.e1.