Prevalence of Surveillance Imaging According to Guidelines After NSCLC Treatment

Published guidelines recommend routine surveillance after treatment for NSCLC to detect recurrences and second primary tumors. However, prior studies to evaluate surveillance after treatment have been limited. Results of a recent study that sought to examine patterns of post-treatment surveillance to identify true rates of adherence and predictors of guideline-concordant care were presented at WCLC 2023 in Singapore.

The researchers used the national Veterans Health Administration database to identify veterans treated for nonmetastatic NSCLC between 2008 and 2016 and ultimately retrieved demographic, clinical, and vital status information on 1537 patients (70.0% were current/former smokers, 96.0% were male, and 44.5% had stage I disease). Guideline-concordant surveillance was defined as a chest computed tomography scan within 120 and 170 days after the first day of treatment or the first day of last treatment with multimodality therapy.

Study results showed that 17.4% of patients received guideline-concordant surveillance and 13.4% received nonconcordant surveillance. Patients were more likely to receive guideline-concordant surveillance if they received chemotherapy plus surgery (P<.001), radiation plus chemotherapy plus surgery (P<.001), or radiation alone (P=.33) compared with those who had surgery alone. The authors concluded that “fewer than one in five patients received guideline-concordant surveillance imaging after NSCLC treatment, and patients receiving surgery as their sole treatment were less likely to receive recommended imaging than others. Further, the rate of concordant imaging did not appear to improve over time. Future efforts should be aimed at interventions to improve surveillance rates and opportunities for at-risk groups.”

Source: Randle R, Ajawara U, Adams S, et al. Adherence to post-treatment surveillance guidelines in non-small cell lung cancer–a Veteran’s Health Administration cohort. Abstract of a poster presented at the 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore.