Lung cancer screening programs can contribute significantly to the incidental identification of esophageal cancer in a high-risk population
Menée aux Etats-Unis à partir de données portant sur 3 893 personnes incluses dans un programme de dépistage du cancer du poumon, cette étude examine la contribution de ce programme dans la détection des cancers de l'oesophage
Lung cancer screening (LCS) also identifies incidental esophageal abnormalities. We report the extent of incidentally found esophageal cancers during our initial 4 years of LCS in a VA (Veterans Affairs) population. A retrospective chart review of a single-center VA Medical Center LCS program in the underserved Southern Appalachia was performed. Esophageal findings of asymptomatic patients and subsequently diagnosed esophageal cancers were recorded and compared to the symptomatically-detected cancers. During the initial 4 years, 3,893 Veterans were screened. Of our healthcare system's detected esophageal cancers, 19% were detected by LCS asymptomatically, with a prevalence of 0.26%. During the same time, the prevalence of symptomatically-detected cancers was 0.097%. The prevalence of the LCS-detected asymptomatic cancers was 2.7× higher than the symptomatic cancers (p = 0.004). The LCS-detected esophageal cancers showed a significantly lower stage (p = 0.025). Strikingly, the number of stage IV cases was only 10% in the LCS group compared to 43% in the symptomatically-detected group. Lung cancer screening in a rural Veteran population identifies esophageal cancers more often than in unscreened Veterans. About 1/389 Veterans undergoing LCS was found to have an asymptomatic esophageal cancer. LCS-detected esophageal cancer presented at a lower stage. LCS programs should be vigilant regarding incidental esophageal findings.
Journal of Medical Screening , résumé, 2025