Time to Diagnosis of Lung Cancer From Identification of a Pulmonary Nodule in the United States
Author(s)
Jonathan S. Kurman, MD, MBA1, Kimberly Le, MBA, MS, PharmD2, Michelle Jerry, MS3, Megan Richards, MPH, PhD3;
1Froedtert Hospital, Milwaukee, WI, USA, 2Biodesix, Director of HEOR, Louisville, CO, USA, 3Merative, Ann Arbor, MI, USA
1Froedtert Hospital, Milwaukee, WI, USA, 2Biodesix, Director of HEOR, Louisville, CO, USA, 3Merative, Ann Arbor, MI, USA
OBJECTIVES: To identify the proportion of pulmonary nodule (PN) patients in the United States who develop lung cancer and the time to development of lung cancer.
METHODS: This retrospective study of patients diagnosed with PNs used data from MarketScan® Commercial and Medicare Databases from 1/1/2013-12/31/2019. Adult patients with a diagnosis of solitary PN (ICD-10: R91.1) between 1/1/2015-12/31/2017 (index date), 24 months of continuous enrollment before and after index date, and no claims for PN or cancer in pre-index period were included. Lung cancer was identified as at least one non-diagnostic claim with a diagnosis code for lung cancer. The number and percentage of patients who developed lung cancer and the time from index to lung cancer diagnosis was reported. Results were stratified by whether the patient received workup during the follow-up period and the earliest type of workup.
RESULTS: Only 37.1% of patients diagnosed with a solitary PN had at least one workup event in the 24 months following diagnosis. 8.5% of patients with workup were diagnosed with lung cancer during follow-up, with a median of 58 days between PN diagnosis and lung cancer diagnosis (mean 168 days). Based on the earliest workup type, 3.6% of patients with CT scans, 28.3% of patients with PET scans, 40.5% of patients with non-surgical biopsies, and 27.0% of patients with surgical resections were diagnosed with lung cancer at some point during follow-up.
CONCLUSIONS: Only about a third of patients with PNs are following up on their nodule within 2 years underscoring the need for better follow-up. Less than half of patients with biopsies or surgeries were diagnosed with cancer, alluding to the need for better strategies to identify candidates for biopsy and surgery in order to avoid unnecessary procedures.
METHODS: This retrospective study of patients diagnosed with PNs used data from MarketScan® Commercial and Medicare Databases from 1/1/2013-12/31/2019. Adult patients with a diagnosis of solitary PN (ICD-10: R91.1) between 1/1/2015-12/31/2017 (index date), 24 months of continuous enrollment before and after index date, and no claims for PN or cancer in pre-index period were included. Lung cancer was identified as at least one non-diagnostic claim with a diagnosis code for lung cancer. The number and percentage of patients who developed lung cancer and the time from index to lung cancer diagnosis was reported. Results were stratified by whether the patient received workup during the follow-up period and the earliest type of workup.
RESULTS: Only 37.1% of patients diagnosed with a solitary PN had at least one workup event in the 24 months following diagnosis. 8.5% of patients with workup were diagnosed with lung cancer during follow-up, with a median of 58 days between PN diagnosis and lung cancer diagnosis (mean 168 days). Based on the earliest workup type, 3.6% of patients with CT scans, 28.3% of patients with PET scans, 40.5% of patients with non-surgical biopsies, and 27.0% of patients with surgical resections were diagnosed with lung cancer at some point during follow-up.
CONCLUSIONS: Only about a third of patients with PNs are following up on their nodule within 2 years underscoring the need for better follow-up. Less than half of patients with biopsies or surgeries were diagnosed with cancer, alluding to the need for better strategies to identify candidates for biopsy and surgery in order to avoid unnecessary procedures.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH17
Topic
Epidemiology & Public Health
Disease
SDC: Oncology, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Surgery