Pilot Study of High Risk Lung Cancer Screening

This study is a prospective trial of 200 individuals at high risk for lung cancer who are not
eligible for lung cancer screening under current screening guidelines. Potential subject's 6
yr lung cancer risk must exceed 1.5% by the Tammamagi PLCO2012m calculator. Patients will
undergo a non contrast CT chest for lung cancer screening. This cutoff should encompass in
excess of 80% of all lung cancer cases (10). However, in patients 78-82 years old we will set
the 6 yr lung cancer risk threshold at 4.0% as these patients will typically have other
competing risks of death and this may potentially limit screening benefit in these older
individuals.

Inclusion Criteria:

1. Adult 40-82 yrs of age.

2. Presenting for lung cancer screening evaluation.

3. Calculated 6 yr lung cancer risk >1.5% for patients 40-77 years of age or >4% for
patients 78-82 years of age.

4. Able and willing to provide informed consent.

Exclusion Criteria:

1. Eligible for clinically indicated lung cancer screening (55-80 yr old, >30 pky smoking
history, still smoking or quit smoking within the last 15 yr).

2. Chest CT performed within the last year.

3. Life expectancy less than 6 months.

4. Symptoms clinically consistent with lung cancer.

5. Unable or unwilling to undergo treatment for lung cancer.

6. Any individual who does not give oral and written consent for participation.