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Table 3 Logistic regression analysis of 294 lung cancer patients, Silkeborg Regional Hospital 2016-2018. Outcome is cTNM stage IA

From: Increased use of diagnostic CT imaging increases the detection of stage IA lung cancer: pathways and patient characteristics

 

cTNM

     
 

IA

Higher

    
 

(85)

(209)

%IA

OR

95% CI

 

Patient characteristics and constitution

Age at diagnosis

 

Median

Median

    
 

72.0

69.9

    

  -59

10

29

25.6

0.60

0.27

1.35

  60–69

26

76

25.5

0.59

0.33

1.07

  70–79

42

73

36.5

1.00

  

  ≥ 80

7

31

18.4

0.39

0.16

0.97

    

Chi2(3) = 5.9; p = 0.11

  

Sex

  Male

40

120

25.0

1.00

  

  Female

45

89

33.6

1.52

0.91

2.52

    

Chi2(1) = 2.6; p = 0.11

  

Charlson comorbidity score

  0

29

99

22.7

1.00

  

  1

21

47

30.9

1.53

0.79

2.95

  2

19

22

46.3

2.95

1.41

6.18

  ≥ 3

16

41

28.1

1.33

0.65

2.71

    

Chi2(3) = 8.3; p = 0.04

  

Pack-years

   ≥ 40

32

99

24.4

1.00

  

  20–39

33

76

30.3

1.34

0.76

2.38

  10–19

9

14

39.1

1.99

0.79

5.03

  0–9

10

8

55.6

3.87

1.41

10.63

  NA

1

12

7.7

0.26

0.03

2.06

    

Chi2(3) = 7.9; p = 0.048 (ex. NA)

  

Morphology

  Small cell carcinoma

2

29

6.5

0.12

0.03

0.52

  Adenocarcinoma

57

99

36.5

1.00

  

  Squamous cell carcinoma

9

39

18.8

0.40

0.18

0.89

  NSCLC unspecified

8

24

25.0

0.58

0.24

1.37

  Other and NA

9

18

33.3

0.87

0.37

2.06

    

Chi2(4) = 12.6; p = 0.01

  

Referral

Initiation of referral

  General practice

38

127

23.0

0.52

0.31

0.87

  Hospital

47

82

36.4

1.00

  
    

Chi2(1) = 6.2; p = 0.01

  

Red flag symptoms (PPV, %)*

  0.0

34

63

35.1

1.36

0.78

2.37

  0.1–0.9

39

98

28.5

1.00

  

  ≥ 1

12

48

20.0

0.63

0.30

1.31

    

Chi2(2) = 4.0; p = 0.13

  

Diagnostics

Initial imaging conclusion

  Suspicious for cancer

40

176

18.5

1.00

  

  Referral for follow-up

36

24

60.0

6.60

3.55

12.27

  Non-suspicious

9

9

50.0

4.40

1.64

11.79

    

Chi2(2) = 38.9; p < 0.001

  

Index image

  CECT

19

46

29.2

1.00

  

  LDCT

25

37

40.3

1.64

0.78

3.42

  Xray

23

87

20.9

0.64

0.32

1.30

  None of the above

18

39

31.6

1.12

0.52

2.42

    

Chi2(3) = 7.4; p = 0.06

  

Imaging cascade

      

  CECT direct

16

42

27.6

1.00

  

  LDCT or ULDCT

22

40

35.5

1.44

0.66

3.14

  Xray then CECT

9

66

12.0

0.36

0.15

0.88

  Xray then LDCT

21

28

42.9

1.97

0.88

4.41

  Other

17

33

34.0

1.35

0.60

3.07

    

Chi2(4) = 15.5; p = 0.004

  

Clinical pathway

      

  Pathway

      

  Lung cancer referral pathway

5

19

20.8

1.00

  

  Urgent referral pathway for non-specific serious symptoms

12

33

26.7

1.38

0.42

4.52

  LDCT pathway

25

37

40.3

2.57

0.85

7.78

  Not a defined clinical pathway

43

120

26.4

1.36

0.48

3.87

    

Chi2(3) = 5.2; p = 0.16

  

Timing of investigation and diagnosis

      

Days from investigation to diagnosis

  Less than 31

42

180

18.9

1.00

  

  31–60

8

11

42.1

3.12

1.18

8.23

  61–179

12

8

60.0

6.43

2.47

16.72

  ≥ 180

23

10

69.7

9.86

4.36

22.27

    

Chi2(3) = 41.1; p < 0.001

  
  1. Six patients with missing value for clinical stage are not included
  2. *Red flag symptoms: none, cough, fatigue, dyspnoea, chest pain, loss of weight, loss of appetite, abnormal spirometry, thrombocytosis, and haemoptysis