Abstract LB146: Imaging surveillance practice patterns among older adults with stage I/II non-small cell lung cancer
Authors: Wheeler Meghann , Karanth Shama , Yang Danting , Washington Caretia , Aduse-Poku Livingstone , Yoon Hyung-Suk (Alex) , Bian Jiang , Guo Yi , Braithwaite Dejana 
Published: April 2023

Background: Following completion of curative-intent treatment, patients with non-small cell lung cancer (NSCLC) are recommended to undergo routine imaging surveillance to detect potential cancer recurrence. We aimed to evaluate adherence to guideline recommended imaging surveillance and factors associated with either adherence or non-adherence.

Methods: We utilized data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Program for the years 2003-2016. Participants were included if they were diagnosed with stage I/II NSCLC, survived for more than 2 years following completion of treatment, between the ages of 65-85, and received either surgical resection or stereotactic body radiotherapy (SBRT) as their primary treatment. Participants were considered to have received guideline-recommended imaging surveillance if there was record of receiving at least one computed tomography (CT) or chest x-ray (CXR) during the following four time windows following completion of curative intent treatment: 90-270 days, 360-450 days, 540-630 days, and 720-810 days. Logistic regression analysis was used to evaluate whether race/ethnicity, sex, age group, treatment type, stage of disease, histology, insurance status, marital status, and comorbidity burden were associated with adherence to guideline-recommended imaging surveillance. All analyses were performed using SAS 9.4.

Results: A total of 14,296 NSCLC patients were included in the present analysis. Most participants were male (57.9%) and Non-Hispanic (NH) white (85.8%). Notably, only 21.9% of patients received guideline-recommended imaging surveillance during the entire 2-year follow-up period. When evaluating adherence within the first year of follow up only, 51.1% of participants met adherence criteria. Factors associated with receipt of guideline-recommended surveillance during the 2-year surveillance period include being married (OR: 1.17; 95% CI:1.06-1.29), receipt of neoadjuvant systemic therapy (OR: 1.76, 95% CI: 1.12-2.76), and a Charlson comorbidity score of &gt;=3 (OR: 1.17, 95% CI: 1.03-1.33). Factors associated with not receiving guideline-recommended imaging surveillance included NH Black race (OR: 0.73, 95% CI: 0.59-0.91) and receipt of adjuvant systemic therapy (OR: 0.68, 95% CI:0.57-0.81), adjuvant radiotherapy (OR: 0.50, 95% CI: 0.40-0.61), or SBRT only (OR: 0.74, 95% CI: 0.63-0.87).

Conclusion: Adherence to guideline-recommended imaging surveillance is low in this population. Strategies to increase compliance to imaging surveillance, particularly among NH black populations, are needed.

Citation Format: Meghann Wheeler, Shama Karanth, Danting Yang, Caretia Washington, Livingstone Aduse-Poku, Hyung-Suk (Alex) Yoon, Jiang Bian, Yi Guo, Dejana Braithwaite. Imaging surveillance practice patterns among older adults with stage I/II non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB146.