Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

• Published in: BMC pulmonary medicine Vol. 17; no. 1; pp. 155 - 8
• Main Authors: Silva, Mario, Sverzellati, Nicola, Colombi, Davide, Milanese, Gianluca, La Vecchia, Carlo, Galeone, Carlotta, Marchianò, Alfonso, Pastorino, Ugo
• Format: Journal Article
• Language: English
• Published: London BioMed Central 25.11.2017; BioMed Central Ltd; BMC
• Subjects: Aged; Analysis; Asbestos - adverse effects; Asbestos exposure; Cancer; Cancer screening; Care and treatment; CAT scans; Critical Care Medicine; Diagnosis; Early Detection of Cancer; Health aspects; Humans; Incidence; Intensive; Internal Medicine; Italy - epidemiology; Lung cancer; Lung cancer screening; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - mortality; Male; Medicine; Medicine & Public Health; Methods; Middle Aged; Occupational Exposure - adverse effects; Pleural abnormalities; Pleural Diseases - diagnostic imaging; Pleural Diseases - mortality; Pleural plaques; Pneumology/Respiratory System; Post-test refinement of individual risk; Research Article; Risk Factors; Self-disclosure of asbestos exposure; Tomography, X-Ray Computed; Italy; Self-disclosure of asbestos exposure; Pleural abnormalities; Lung cancer screening; Pleural plaques; Post-test refinement of individual risk; Asbestos exposure
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-017-0506-3

Background To report the prevalence of pleural plaques in a lung cancer screening trial by low-dose computed tomography (LDCT) and to test the association with incidence of lung cancer and mortality. Methods The LDCT of 2303 screenees were retrospectively reviewed with the specific aim of describing the prevalence and features of pleural plaques. Self-administered questionnaire was used to assess asbestos exposure. Frequency of lung cancer, lung cancer mortality, and overall mortality were detailed according to presence of pleural findings. Statistical analyses included comparison of mean or median, contingency tables, and Cox model for calculation of hazard ratio (HR) and its 95% confidence interval (CI). Results Among male screenees, 31/1570 (2%) showed pleural abnormalities, 128/1570 (8.2%) disclosed asbestos exposure, 23/31 (74.2%) subjects with pleural plaques consistently denied exposure to asbestos. There was a trend for higher frequency of lung cancer among subjects with pleural plaques (9.7% vs 4.2%). Lung cancer in subjects with pleural plaques was always diagnosed in advanced stage. Subjects with pleural plaques showed HR 5.48 (95% CI 1.61–18.70) for mortality from lung cancer. Conclusions Pleural plaques are a risk factor for lung cancer mortality that can be detected in lung cancer screening by LDCT, also in subjects that are not aware of asbestos exposure. Trial registration NCT02837809 - Retrospectively registered July 1, 2016 - Enrolment of first participant September 2005.