PMID- 31005338
OWN - NLM
STAT- MEDLINE
DCOM- 20191220
LR  - 20200701
IS  - 1532-818X (Electronic)
IS  - 0196-0709 (Print)
IS  - 0196-0709 (Linking)
VI  - 40
IP  - 4
DP  - 2019 Jul-Aug
TI  - Clinical practice patterns in laryngeal cancer and introduction of CT lung 
      screening.
PG  - 520-524
LID - S0196-0709(19)30311-4 [pii]
LID - 10.1016/j.amjoto.2019.04.010 [doi]
AB  - OBJECTIVES: After the publication of large clinical trials, in January 2014 The 
      U.S. Preventive Services Task Force (USPSTF) recommended annual lung cancer 
      screening with low-dose CT in a well-defined group of high-risk smokers. A 
      significant proportion of patients with laryngeal cancer (LC) meet the introduced 
      criteria, and we hypothesized that clinical practice would change as a result of 
      these evidence-based guidelines. METHODS: Retrospective chart review of patients 
      diagnosed with LC and treated at Johns Hopkins Hospital who met USPSTF criteria 
      for annual chest screening and were followed for at least 3 consecutive years in 
      the years surrounding the introduction of screening guidelines (January 2010 to 
      December 2017) was performed to identify those who had recommended screening CT 
      chest. RESULTS: A total of 151 patients met the inclusion criteria of the study 
      and were followed for a total of 746 patient-years. 184/332 (55%) patient-years 
      in the pre-guidelines period and 246/414 (59%) in the post-guidelines period 
      included at least one recommended chest imaging (CT or PET-CT; p = 0.27). 248/332 
      (75%) patient-years in the pre-guidelines period and 314/414 (76%) in the 
      post-guidelines period included any radiological chest imaging (X-ray, CT or 
      PET-CT; p = 0.72). Screening scans were ordered by OHNS (45%), Medical Oncology 
      (31%), Radiation Oncology (8%), and primary care (14%) with 70% of patients 
      missing at least one year of indicated screening. CONCLUSIONS: The implementation 
      of new lung cancer screening guidelines did not change clinical practice in the 
      management of patients with LC and many patients do not receive recommended 
      screening. Further study concerning potential barriers to effective 
      evidence-based screening and coordination of care is warranted.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Piersiala, Krzysztof
AU  - Piersiala K
AD  - Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, 
      Baltimore, MD, United States of America; Division of ENT Diseases, Department of 
      Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, 
      Sweden.
FAU - Akst, Lee M
AU  - Akst LM
AD  - Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, 
      Baltimore, MD, United States of America.
FAU - Hillel, Alexander T
AU  - Hillel AT
AD  - Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, 
      Baltimore, MD, United States of America.
FAU - Best, Simon R
AU  - Best SR
AD  - Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, 
      Baltimore, MD, United States of America. Electronic address: Sbest2@jhmi.edu.
LA  - eng
GR  - K23 DC014758/DC/NIDCD NIH HHS/United States
GR  - L40 DC013350/DC/NIDCD NIH HHS/United States
PT  - Journal Article
DEP - 20190412
PL  - United States
TA  - Am J Otolaryngol
JT  - American journal of otolaryngology
JID - 8000029
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Evidence-Based Practice
MH  - Female
MH  - Humans
MH  - Laryngeal Neoplasms/*diagnostic imaging/*prevention & control
MH  - Lung Neoplasms/*diagnostic imaging/*prevention & control
MH  - Male
MH  - *Mass Screening
MH  - Middle Aged
MH  - Positron Emission Tomography Computed Tomography
MH  - Practice Guidelines as Topic
MH  - *Practice Patterns, Physicians'
MH  - Smokers
MH  - Tomography, X-Ray Computed
PMC - PMC6570546
MID - NIHMS1527590
OTO - NOTNLM
OT  - CT
OT  - Head and neck cancer
OT  - Laryngeal cancer
OT  - Lung cancer
OT  - Lung cancer screening
COIS- Conflict of Interest: None of the authors have any conflicts of interest or 
      financial ties to disclose. The authors whose names are listed immediately above 
      certify that they have NO affiliations or involvement in any organization or 
      entity with any financial interest or non-financial interest in the subject 
      matter or materials discussed in this manuscript.
EDAT- 2019/04/22 06:00
MHDA- 2019/12/21 06:00
PMCR- 2020/07/01
CRDT- 2019/04/22 06:00
PHST- 2019/04/08 00:00 [received]
PHST- 2019/04/12 00:00 [accepted]
PHST- 2019/04/22 06:00 [pubmed]
PHST- 2019/12/21 06:00 [medline]
PHST- 2019/04/22 06:00 [entrez]
PHST- 2020/07/01 00:00 [pmc-release]
AID - S0196-0709(19)30311-4 [pii]
AID - 10.1016/j.amjoto.2019.04.010 [doi]
PST - ppublish
SO  - Am J Otolaryngol. 2019 Jul-Aug;40(4):520-524. doi: 10.1016/j.amjoto.2019.04.010. 
      Epub 2019 Apr 12.