2023 World Conference on Lung Cancer (Posters)-P1.28. Adherence to Post-treatment Surveillance Guidelines in Non-small Cell Lung Cancer - A Veteran’s Health Administration Cohort

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This study aimed to estimate the rate of adherence to post-treatment surveillance guidelines for non-small cell lung cancer (NSCLC) and identify predictors associated with receiving surveillance. Data from the Veterans Health Administration (VHA) electronic health records database were analyzed for NSCLC patients between 2008-2016. Patients who did not receive curative intent treatment, died within 6 months after therapy, had stage 4 cancer presentation, had lung cancer prior to 2008, or had a non-skin cancer diagnosis within the past 5 years were excluded.<br /><br />The researchers abstracted radiology reports to determine the image modality, image indication, and occurrence of recurrence or second primary lung cancer (SPLC). Adherent surveillance was defined as the receipt of chest CT performed for surveillance purposes within 120-270 days following the first day of treatment or the first day of last treatment with multimodality therapy. The probability of receiving guideline-concordant imaging was assessed using the competing risks framework Aalen-Johansen estimator.<br /><br />The study found that the rate of guideline-concordant surveillance in the national cohort was 17.4%, which is lower than other published studies. Patients who underwent surgery combined with chemotherapy or radiation were more likely to undergo guideline-concordant surveillance during the initial surveillance window compared to patients who only received surgery. The majority of eligible patients did not receive surveillance imaging that adhered to expert guidelines, and patients who received surgery alone appeared to be at the greatest risk.<br /><br />Factors such as therapy type, disease stage, year of diagnosis, age, and Charlson Comorbidity Index were evaluated as potential predictors of guideline-concordant surveillance. The results showed that patients who underwent surgery combined with chemotherapy or surgery combined with chemotherapy and radiation had a higher likelihood of receiving guideline-concordant surveillance. The study did not find a significant association between disease stage, year of diagnosis, age, or Charlson Comorbidity Index and the likelihood of receiving guideline-concordant surveillance.<br /><br />In conclusion, this study highlights the low rate of adherence to post-treatment surveillance guidelines for NSCLC in the VHA cohort. Patients who received surgery alone were particularly at risk of not receiving guideline-concordant surveillance. Strategies to increase adherence to surveillance guidelines should be implemented to improve outcomes for NSCLC patients.

Asset Subtitle

Ryan Randle

Meta Tag

Speaker Ryan Randle

Topic Local-Regional NSCLC

Keywords

adherence

post-treatment surveillance

non-small cell lung cancer

NSCLC

predictors

surveillance guidelines

Veterans Health Administration

electronic health records database

curative intent treatment

stage 4 cancer presentation