Data from 20 observational studies including nearly 3000 pts were reviewed to assess the prevalence of pre-frailty/frailty and clinical outcomes in older cancer patients. Frailty was identified in 42% and pre-frailty in 43% of patients. Combined frailty was associated with increased all cause mortality (5-yr HR 1.57), postoperative mortality, and p
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Lung Cancer - Other
November 20, 2014
November 11, 2014
CMS determined that the evidence of benefit for CT screening for lung cancer is sufficient to permit this as an annual benefit for Medicare and Medicaid recipients in the US. The availability of such coverage will be limited, however, by the need to have the screening as part of a comprehensive counseling (smoking cessation, etc) visit with qualifie
November 5, 2014
The authors examined cost-effectiveness in the National Lung Screening Trial (NLST), examining incremental cost-effectiveness ratio (ICER) and quality-adjusted life years (QALYs) associated with low dose CT screening. The ICER was $52,000 per life-year gained and the $81,000 per QALY gained. These values were very sensitive to variations in the scr
October 16, 2014
Because of the observation that already debilitated pts who undergo lung resection become even more debilitated afterwards, the authors conducted a randomized trial of endurance and strength training for 20 wks after major lung resection. Training significantly improved peak VO2, DLCO, strength, endurance, and muscle mass compared to controls. Qual
Active and passive smoking in relation to lung cancer incidence in the Women's Health Initiative Observational Study prospective cohort
October 15, 2014
Using a data set of over 76,000 women from the Women's Health Initiative Observational Study, the effects of active and passive smoking on cancer were evaluated. Lung cancer incidence was highest among active smokers (HR 13.44) and was also high among prior smokers (HR 4.20). A prolonged exposure (>30 yr) to passive smoking in the household also
What characteristics of primary care and patients are associated with early death in patients with lung cancer in the UK?
October 14, 2014
Lung cancer cases 2000-2013 in the UK Health Improvement Network were evaluated for factors associated with early death (within 90 days of diagnosis) vs later death. Risk factors for early death included male sex, older age, current smoking, social deprivation, and rural location. Those experiencing early death saw their primary care physicians mor
Resource Utilization and Costs during the Initial Years of Lung Cancer Screening with Computed Tomography in Canada
September 25, 2014
Costs of lung cancer screening were determined for individuals with a 2% or greater risk of lung cancer over 3 years for 2059 subjects participating in the Pan-Canadian Early Detection of Lung Cancer Study. During the first 18 mos of screening the per-person cost was $453. Surgical therapy cost $33,344 over 2 years compared to costs of treating adv
September 25, 2014
A model for predicting lung cancer in patients with suspicious lung nodules (TREAT) was developed using single institutional data (Vanderbilt), validated using data from another institution, and compared to the Mayo Clinic predictive model. The model accuracy was 87% in the development cohort and 89% in the validation cohort, compared to 80% in the
September 25, 2014
This meta-analysis of 70 studies evaluated the utility of PET in assessing over 8,511 lung nodules, comparing regions in which infectious lung disease is endemic to other regions. Specificity was lower in regions with endemic infectious diseases, 61% vs 77%. Overall, the accuracy of PET was extremely heterogeneous.
September 5, 2014
Screening for lung cancer with low-dose CT has been shown to save lives, but few people who qualify for screening actually receive it. This study examined the use of the electronic medical record to identify pts at risk due to a smoking history. Prior to initiation, the annualized rate of referral for screening was 16 pts. After initiation the ann