12 results on '"Midthun, David E."'
Search Results
2. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.
- Author
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Wood DE, Kazerooni EA, Baum SL, Eapen GA, Ettinger DS, Hou L, Jackman DM, Klippenstein D, Kumar R, Lackner RP, Leard LE, Lennes IT, Leung ANC, Makani SS, Massion PP, Mazzone P, Merritt RE, Meyers BF, Midthun DE, Pipavath S, Pratt C, Reddy C, Reid ME, Rotter AJ, Sachs PB, Schabath MB, Schiebler ML, Tong BC, Travis WD, Wei B, Yang SC, Gregory KM, and Hughes M
- Subjects
- Clinical Decision-Making, Cost-Benefit Analysis, Early Detection of Cancer methods, Humans, Lung Neoplasms epidemiology, Multimodal Imaging methods, Randomized Controlled Trials as Topic, Reproducibility of Results, Risk Assessment, Risk Factors, Tumor Burden, United States, Lung Neoplasms diagnosis, Mass Screening methods, Tomography, X-Ray Computed methods
- Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. Early detection of lung cancer is an important opportunity for decreasing mortality. Data support using low-dose computed tomography (LDCT) of the chest to screen select patients who are at high risk for lung cancer. Lung screening is covered under the Affordable Care Act for individuals with high-risk factors. The Centers for Medicare & Medicaid Services (CMS) covers annual screening LDCT for appropriate Medicare beneficiaries at high risk for lung cancer if they also receive counseling and participate in shared decision-making before screening. The complete version of the NCCN Guidelines for Lung Cancer Screening provides recommendations for initial and subsequent LDCT screening and provides more detail about LDCT screening. This manuscript focuses on identifying patients at high risk for lung cancer who are candidates for LDCT of the chest and on evaluating initial screening findings., (Copyright © 2018 by the National Comprehensive Cancer Network.)
- Published
- 2018
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3. An official American Thoracic Society/American College of Chest Physicians policy statement: implementation of low-dose computed tomography lung cancer screening programs in clinical practice.
- Author
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Wiener RS, Gould MK, Arenberg DA, Au DH, Fennig K, Lamb CR, Mazzone PJ, Midthun DE, Napoli M, Ost DE, Powell CA, Rivera MP, Slatore CG, Tanner NT, Vachani A, Wisnivesky JP, and Yoon SH
- Subjects
- Humans, Mass Screening economics, Radiation Dosage, Radiography, Thoracic standards, Smoking Cessation, Societies, Medical, Solitary Pulmonary Nodule diagnostic imaging, Tomography, X-Ray Computed, United States, Lung Neoplasms diagnostic imaging, Mass Screening standards
- Abstract
Rationale: Annual low-radiation-dose computed tomography (LDCT) screening for lung cancer has been shown to reduce lung cancer mortality among high-risk individuals and is now recommended by multiple organizations. However, LDCT screening is complex, and implementation requires careful planning to ensure benefits outweigh harms. Little guidance has been provided for sites wishing to develop and implement lung cancer screening programs., Objectives: To promote successful implementation of comprehensive LDCT screening programs that are safe, effective, and sustainable., Methods: The American Thoracic Society (ATS) and American College of Chest Physicians (ACCP) convened a committee with expertise in lung cancer screening, pulmonary nodule evaluation, and implementation science. The committee reviewed the evidence from systematic reviews, clinical practice guidelines, surveys, and the experience of early-adopting LDCT screening programs and summarized potential strategies to implement LDCT screening programs successfully., Measurements and Main Results: We address steps that sites should consider during the main three phases of developing an LDCT screening program: planning, implementation, and maintenance. We present multiple strategies to implement the nine core elements of comprehensive lung cancer screening programs enumerated in a recent ACCP/ATS statement, which will allow sites to select the strategy that best fits with their local context and workflow patterns. Although we do not comment on cost-effectiveness of LDCT screening, we outline the necessary costs associated with starting and sustaining a high-quality LDCT screening program., Conclusions: Following the strategies delineated in this policy statement may help sites to develop comprehensive LDCT screening programs that are safe and effective.
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- 2015
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4. Screening for lung cancer: for patients at increased risk for lung cancer, it works.
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Jett JR and Midthun DE
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- Age Factors, Aged, Early Detection of Cancer, False Positive Reactions, Female, Humans, Lung Neoplasms etiology, Lung Neoplasms mortality, Lung Neoplasms prevention & control, Middle Aged, Radiation Dosage, Risk Factors, United States epidemiology, Lung Neoplasms diagnostic imaging, Mass Screening adverse effects, Mass Screening methods, Smoking adverse effects, Tomography, X-Ray Computed adverse effects, Tomography, X-Ray Computed methods, Tomography, X-Ray Computed standards
- Abstract
Screening for lung cancer is not currently recommended, even in persons at high risk for this condition. Most patients with lung cancer present with symptomatic disease that is usually at an incurable, advanced stage. The recently reported NLST (National Lung Screening Trial) showed a 20% decrease in deaths from lung cancer in high-risk persons undergoing screening with low-dose computed tomography of the chest compared with chest radiography. The high-risk group included in the trial comprised asymptomatic persons aged 55 to 74 years, with smoking history of at least 30 pack-years. Screening with low-dose computed tomography detected more cases of early-stage lung cancer and fewer cases of advanced-stage cancer, confirming that screening has shifted the stage of cancer at diagnosis and provides more persons with the opportunity for curative treatment. Although computed tomography screening has risks and limitations, the 20% decrease in deaths is the single most dramatic decrease ever reported for deaths from lung cancer, with the possible exception of smoking cessation. Physicians should offer computed tomography screening for lung cancer to patients who fit the high-risk profile defined in the NLST.
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- 2011
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5. Lung cancer: evolving concepts.
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Midthun DE and Molina JR
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- Humans, Lung Neoplasms diagnosis, Lung Neoplasms pathology, Risk Factors, Smoking adverse effects, United States, Lung Neoplasms therapy, Mass Screening methods
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- 2011
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6. Update on screening for lung cancer.
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Midthun DE and Jett JR
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- Bias, Biomarkers, Tumor genetics, Humans, Lung Neoplasms epidemiology, Lung Neoplasms genetics, Mass Screening trends, Prognosis, Sputum cytology, Tomography, X-Ray Computed, Lung Neoplasms diagnosis, Mass Screening methods
- Abstract
Prognosis of lung cancer is markedly improved when cancers are resected in early stages (particularly in stage I). Previous investigations failed to show benefit with use of chest radiographs or sputum cytologies to screen for lung cancer among high-risk populations. More recently, computed tomography (CT) has been used as a screening technique and appears to detect lung cancer at earlier stages (e.g., stage I) compared with usual clinical practice. However, whether screening CT reduces death from lung cancer has not been clarified. This review examines the problem presented by lung cancer, the issues presented by screening, and the results of past and recent studies of lung cancer screening.
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- 2008
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7. Commentary: CT screening for lung cancer--caveat emptor.
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Jett JR and Midthun DE
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- Biopsy, False Positive Reactions, Humans, Lung Diseases diagnostic imaging, Lung Diseases surgery, Lung Neoplasms prevention & control, Risk Factors, Survival Rate, United States epidemiology, Unnecessary Procedures, Lung Neoplasms diagnostic imaging, Lung Neoplasms mortality, Mass Screening methods, Radiation Injuries etiology, Tomography, X-Ray Computed adverse effects
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- 2008
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8. Five-year lung cancer screening experience: CT appearance, growth rate, location, and histologic features of 61 lung cancers.
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Lindell RM, Hartman TE, Swensen SJ, Jett JR, Midthun DE, Tazelaar HD, and Mandrekar JN
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- Adenocarcinoma diagnostic imaging, Adenocarcinoma pathology, Adenocarcinoma, Bronchiolo-Alveolar diagnostic imaging, Adenocarcinoma, Bronchiolo-Alveolar pathology, Aged, Carcinoma, Large Cell diagnostic imaging, Carcinoma, Large Cell pathology, Carcinoma, Neuroendocrine diagnostic imaging, Carcinoma, Neuroendocrine pathology, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Small Cell diagnostic imaging, Carcinoma, Small Cell pathology, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell pathology, Female, Follow-Up Studies, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Retrospective Studies, Sex Factors, Lung Neoplasms prevention & control, Mass Screening, Tomography, X-Ray Computed methods
- Abstract
Purpose: To retrospectively evaluate the computed tomography (CT)-determined size, morphology, location, morphologic change, and growth rate of incidence and prevalence lung cancers detected in high-risk individuals who underwent annual chest CT screening for 5 years and to evaluate the histologic features and stages of these cancers., Materials and Methods: The study was institutional review board approved and HIPAA compliant. Informed consent was waived. CT scans of 61 cancers (24 in men, 37 in women; age range, 53-79 years; mean, 65 years) were retrospectively reviewed for cancer size, morphology, and location. Forty-eight cancers were assessed for morphologic change and volume doubling time (VDT), which was calculated by using a modified Schwartz equation. Histologic sections were retrospectively reviewed., Results: Mean tumor size was 16.4 mm (range, 5.5-52.5 mm). Most common CT morphologic features were as follows: for bronchioloalveolar carcinoma (BAC) (n = 9), ground-glass attenuation (n = 6, 67%) and smooth (n = 3, 33%), irregular (n = 3, 33%), or spiculated (n = 3, 33%) margin; for non-BAC adenocarcinomas (n = 25), semisolid (n = 11, 44%) or solid (n = 12, 48%) attenuation and irregular margin (n = 14, 56%); for squamous cell carcinoma (n = 14), solid attenuation (n = 12, 86%) and irregular margin (n = 10, 71%); for small cell or mixed small and large cell neuroendocrine carcinoma (n = 7), solid attenuation (n = 6, 86%) and irregular margin (n = 5, 71%); for non-small cell carcinoma not otherwise specified (n = 5), solid attenuation (n = 4, 80%) and irregular margin (n = 3, 60%); and for large cell carcinoma (n = 1), solid attenuation and spiculated shape (n = 1, 100%). Attenuation most often (in 12 of 21 cases) increased. Margins most often (in 16 of 20 cases) became more irregular or spiculated. Mean VDT was 518 days. Thirteen of 48 cancers had a VDT longer than 400 days; 11 of these 13 cancers were in women., Conclusion: Overdiagnosis, especially in women, may be a substantial concern in lung cancer screening., ((c) RSNA, 2007.)
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- 2007
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9. Lung cancer screening experience: a retrospective review of PET in 22 non-small cell lung carcinomas detected on screening chest CT in a high-risk population.
- Author
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Lindell RM, Hartman TE, Swensen SJ, Jett JR, Midthun DE, Nathan MA, and Lowe VJ
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- Carcinoma, Non-Small-Cell Lung epidemiology, Female, Humans, Incidence, Lung Neoplasms epidemiology, Male, Prevalence, Retrospective Studies, Solitary Pulmonary Nodule diagnostic imaging, Solitary Pulmonary Nodule epidemiology, Carcinoma, Non-Small-Cell Lung diagnostic imaging, Lung Neoplasms diagnostic imaging, Mass Screening methods, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Objective: The objective of our study was to retrospectively review the PET results of non-small cell lung carcinomas detected on screening chest CT in a high-risk population., Conclusion: PET findings were negative in 32% of the cases of non-small cell carcinomas that were detected on screening CT in a high-risk patient population. These tumors were small, low-grade, or both. The most common histology was bronchioloalveolar cell carcinoma. The role of PET in evaluating screening-detected indeterminate nodules in a high-risk population may be more limited than in a general population.
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- 2005
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10. Computed tomographic screening for lung cancer: home run or foul ball?
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Swensen SJ, Jett JR, Midthun DE, and Hartman TE
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- Ethics, Medical, Humans, United States, Lung Neoplasms diagnostic imaging, Mass Screening methods, Tomography, X-Ray Computed
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- 2003
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11. Lung cancer screening with CT: Mayo Clinic experience.
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Swensen SJ, Jett JR, Hartman TE, Midthun DE, Sloan JA, Sykes AM, Aughenbaugh GL, and Clemens MA
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- Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Lung Neoplasms epidemiology, Male, Middle Aged, Minnesota epidemiology, Neoplasm Staging, Prevalence, Prospective Studies, Risk Factors, Smoking adverse effects, Lung Neoplasms diagnostic imaging, Mass Screening, Tomography, Spiral Computed
- Abstract
Purpose: To evaluate a large cohort of patients at high risk for lung cancer by using screening with low-dose spiral computed tomography (CT) of the chest., Materials and Methods: A prospective cohort study was performed with 1,520 individuals aged 50 years or older who had smoked 20 pack-years or more. Participants underwent three annual low-dose CT examinations of the chest and upper abdomen. Characteristics of pulmonary nodules and additional findings were tabulated and analyzed., Results: Two years after baseline CT scanning, 2,832 uncalcified pulmonary nodules were identified in 1,049 participants (69%). Forty cases of lung cancer were diagnosed: 26 at baseline (prevalence) CT examinations and 10 at subsequent annual (incidence) CT examinations. CT alone depicted 36 cases; sputum cytologic examination alone, two. There were two interval cancers. Cell types were as follows: squamous cell tumor, seven; adenocarcinoma or bronchioloalveolar carcinoma, 24; large cell tumor, two; non-small cell tumor, three; small cell tumor, four. The mean size of the non-small cell cancers detected at CT was 15.0 mm. The stages were as follows: IA, 22; IB, three; IIA, four; IIB, one; IIIA, five; IV, one; limited small cell tumor, four. Twenty-one (60%) of the 35 non-small cell cancers detected at CT were stage IA at diagnosis. Six hundred ninety-six additional findings of clinical importance were identified., Conclusion: CT can depict early-stage lung cancers. The rate of benign nodule detection is high.
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- 2003
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12. Screening for lung cancer with low-dose spiral computed tomography.
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Swensen SJ, Jett JR, Sloan JA, Midthun DE, Hartman TE, Sykes AM, Aughenbaugh GL, Zink FE, Hillman SL, Noetzel GR, Marks RS, Clayton AC, and Pairolero PC
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- Aged, False Positive Reactions, Female, Humans, Incidence, Lung Neoplasms epidemiology, Lung Neoplasms pathology, Male, Middle Aged, Prevalence, Prospective Studies, Smoking, Sputum cytology, United States epidemiology, Lung Neoplasms diagnostic imaging, Lung Neoplasms prevention & control, Mass Screening, Tomography, X-Ray Computed
- Abstract
Studies suggest that screening with spiral computed tomography can detect lung cancers at a smaller size and earlier stage than chest radiography can. To evaluate low-radiation-dose spiral computed tomography and sputum cytology in screening for lung cancer, we enrolled 1,520 individuals aged 50 yr or older who had smoked 20 pack-years or more in a prospective cohort study. One year after baseline scanning, 2,244 uncalcified lung nodules were identified in 1,000 participants (66%). Twenty-five cases of lung cancer were diagnosed (22 prevalence, 3 incidence). Computed tomography alone detected 23 cases; sputum cytology alone detected 2 cases. Cell types were: squamous cell, 6; adenocarcinoma or bronchioalveolar, 15; large cell, 1; small cell, 3. Twenty-two patients underwent curative surgical resection. Seven benign nodules were resected. The mean size of the non-small cell cancers detected by computed tomography was 17 mm (median, 13 mm). The postsurgical stage was IA, 13; IB, 1; IIA, 5; IIB, 1; IIIA, 2; limited, 3. Twelve (57%) of the 21 non-small cell cancers detected by computed tomography were stage IA at diagnosis. Computed tomography can detect early-stage lung cancers. The rate of benign nodule detection is high.
- Published
- 2002
- Full Text
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