Characteristics of a Female Veteran Population with Cancer Referred to Pulmonary Nodule Clinic
Year: 2021
Type: conference-abstract
Abstract: Rationale: Lung cancer remains the leading cause of cancer deaths in the United States and the number of nodules detected on radiographic studies continues to increase.Despite the presence of guidelines standardizing lung cancer screening and management of incidental nodules, the characteristics and evaluation of nodules in female patients remains elusive.This may lead to diagnostic uncertainty and may delay diagnosis.In an effort to explore the characteristics of nodules in female patients with lung cancer we reviewed our cohort of female veterans diagnosed with lung cancer in our pulmonary nodule clinic (PNC).Methods: All female veterans referred to our PNC were reviewed.Data acquisition was from 2013 to July 2020.We evaluated initial imaging modality, comorbidities, tobacco use, and diagnostic workup, including presentation to multidisciplinary conference (MDC), biopsy type and clinical stage at time of diagnosis.Results: A total of 77 female veterans were enrolled in PNC during the data collection period.Ten veterans were diagnosed with cancer.The average age of the cancer subgroup was 61 years old.The majority had adenocarcinoma (60%) followed by squamous cell, small cell and carcinoid.Adenocarcinoma and carcinoid were diagnosed in patients who never smoked.Seventy percent of malignancies were found incidentally, there was a wide range in time to diagnosis, and all nodules were greater then 8mm.Eighty percent of nodules were solid, and the remainder were mixed.More than half were discussed at MDC, all had pre-biopsy positron emission tomography scans, and eighty percent underwent endobronchial ultrasound with transbronchial needle aspiration.The majority presented with late-stage disease and there was a significant association between tobacco use with cancer diagnosis.Most carried a diagnosis of chronic obstructive pulmonary disease and had imaging findings of smoking related lung disease.There was excellent follow-up and adherence to treatment plans.Conclusion: There is emerging evidence that coordinated care through PNC may improve patient outcomes and streamline clinical evaluation.Here we present an analysis of a female veteran cohort evaluated in a PNC.In this small sample size, most patients had non-small cell lung cancer, and there was wide variation in time to diagnosis from referral.The delay in diagnosis perhaps represents radiographic challenges in diagnosing early lung cancer, and the low rates of screening imaging may represent a lack of referral for the appropriate patient.Further work is needed to improve lung cancer screening rates and understand limitations in nodule risk stratification.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4235249599