• non‐small cell lung cancer
• prognosis
• segmentectomy
• surgery
• wedge resection

• Humans
• Female
• Lung Neoplasms/surgery
• Lung Neoplasms/mortality
• Lung Neoplasms/pathology
• Pneumonectomy/methods
• Pneumonectomy/mortality
• Male
• Retrospective Studies
• Aged
• Middle Aged
• Survival Rate
• Aged, 80 and over
• Adult

• The authors received no specific funding for this work.

• Biomarkers
• Lung Cancer
• Outcomes
• Second Primary Lung Cancer
• Survival

• Humans
• Lung Neoplasms/pathology
• Neoplasms, Second Primary/pathology
• Cancer Survivors

• Aged
• Female
• Humans
• Male
• Middle Aged
• Asian
• Black or African American
• Cancer Survivors
• Cohort Studies
• Hispanic or Latino
• Incidence
• Lung Neoplasms/ethnology
• Lung Neoplasms/mortality
• Native Hawaiian or Other Pacific Islander
• Neoplasms, Second Primary/ethnology
• Neoplasms, Second Primary/epidemiology
• SEER Program
• United States/epidemiology
• White

• R01 CA282793 NCI NIH HHS
• 1R01CA282793 NIH HHS
• National Institutes of Health

• machine learning
• metachronous second primary lung cancer
• propensity score matching analysis
• radiotherapy
• surgical resection

• Humans
• Carcinoma, Non-Small-Cell Lung/pathology
• Lung Neoplasms/pathology
• Pneumonectomy/adverse effects
• Neoplasms, Second Primary/pathology
• Neoplasm Staging
• Leukemia
• Small Cell Lung Carcinoma

• UG1 CA233290 NCI NIH HHS
• U10 CA180821 NCI NIH HHS
• UG1 CA233324 NCI NIH HHS
• P30 CA008748 NCI NIH HHS
• UG1 CA232760 NCI NIH HHS
• U10 CA180863 NCI NIH HHS
• U10 CA180882 NCI NIH HHS
• UG1 CA233247 NCI NIH HHS
• UG1 CA233253 NCI NIH HHS
• U10 CA180888 NCI NIH HHS
• UG1 CA233184 NCI NIH HHS

• active surveillance
• early detection of cancer
• lung cancer
• risk assessment
• second primary neoplasms

• Humans
• Lung Neoplasms/diagnosis
• Lung Neoplasms/epidemiology
• Lung Neoplasms/therapy
• Cancer Survivors
• Risk
• Smoking
• Neoplasms, Second Primary
• Lung

• 1R01CA282793 NIH HHS
• R37 CA226081 NCI NIH HHS
• R01 CA282793 NCI NIH HHS
• 4R37CA226081 NIH HHS
• P30 CA071789 NCI NIH HHS
• P30 CA124435 NCI NIH HHS

• Humans
• Male
• Female
• Lung Neoplasms
• Cohort Studies
• Smoke
• Cancer Survivors
• Prospective Studies
• Risk Factors
• Neoplasms, Second Primary/epidemiology
• Neoplasms, Second Primary/etiology
• Lung

• R01 CA282793 NCI NIH HHS
• R37 CA226081 NCI NIH HHS

• Follow-up care
• Lung cancer
• Racial differences

• Humans
• Female
• Aged
• Male
• Cancer Survivors
• Aftercare
• Cross-Sectional Studies
• Lung Neoplasms/therapy
• Survivors
• Lung

• R01 CA239093 NCI NIH HHS

• Disparities in diagnosis and staging of lung cancer
• Disparities in lung cancer screening
• Disparities in the treatment of lung cancer
• Lung cancer in minorities

• Lung cancer
• Risk factor
• Second primary extrapulmonary malignancy
• Second primary malignancy

• cancer-specific survival (CSS)
• initial primary lung cancer
• overall survival (OS)
• postoperative radiotherapy
• secondary primary lung cancer
• standardized incidence ratio (SIR)

• National Key Research and Development Program of China
• Chinese Academy of Medical Sciences
• National Natural Science Foundation of China
• Shandong First Medical University

The risk of developing lung cancer is increased in smokers, patients with chronic obstructive pulmonary disease, individuals exposed to environmental carcinogens, and those with a history of lung cancer. Automobile exhaust fumes containing carcinogens are a risk factor for lung cancer. However, we go through life unaware of the fact that automobile exhaust is the cause of cancer. Especially, in lung cancer patient, it is important to search out pre-existing risk factors and advice to avoid them, and monitor carefully for recurrence after treatment.

This is the first report of a case with triple lung cancers with different histologic types at different sites, observed in a 76-year-old parking attendant. The first adenocarcinoma and the second squamous cell carcinoma were treated with stereotactic radiosurgery because the patient did not want to undergo surgery. Although the patient stopped intermittent smoking after the diagnosis, he continued working as a parking attendant in the parking lot. After 29 months from the first treatment, the patient developed a third new small cell lung cancer; he was being treated with chemoradiation.

New mass after treatment of lung cancer might be a multiple primary lung cancer rather than metastasis. Thus, precision evaluation is important. This paper highlights the risk factors for lung cancer that are easily overlooked but should not be dismissed, and the necessity of discussion with patients for the surveillance after lung cancer treatment. We should look over carefully the environmental carcinogens already exposed, and counsel to avoid pre-existing lung cancer risk factors at work or residence in patients with lung cancer.

To report the experience of a routine follow-up program based on medical visits and chest CT.

This was a retrospective study involving patients followed after complete surgical resection of non-small cell lung cancer between April of 2007 and December of 2015. The follow-up program consisted of clinical examination and chest CT. Each follow-up visit was classified as a routine or non-routine consultation, and patients were considered symptomatic or asymptomatic. The outcomes of the follow-up program were no evidence of cancer, recurrence, or second primary lung cancer.

The sample comprised 148 patients. The median time of follow-up was 40.1 months, and 74.3% of the patients underwent fewer chest CTs than those recommended in our follow-up program. Recurrence and second primary lung cancer were found in 17.6% and 11.5% of the patients, respectively. Recurrence was diagnosed in a routine medical consultation in 69.2% of the cases, 57.7% of the patients being asymptomatic. Second primary lung cancer was diagnosed in a routine medical appointment in 94.1% of the cases, 88.2% of the patients being asymptomatic. Of the 53 patients who presented with abnormalities on chest CT, 41 (77.3%) were diagnosed with cancer.

Most of the cases of recurrence, especially those of second primary lung cancer, were confirmed by chest CT in asymptomatic patients, indicating the importance of a strict follow-up program that includes chest CTs after surgical resection of lung cancer.

With advancing therapeutics, lung cancer (LC) survivors are rapidly increasing in number. Although mounting evidence suggests LC survivors have high risk of second primary lung cancer (SPLC), there is no validated prediction model available for clinical use to identify high-risk LC survivors for SPLC.

Using data from 6325 ever-smokers in the Multiethnic Cohort (MEC) study diagnosed with initial primary lung cancer (IPLC) in 1993-2017, we developed a prediction model for 10-year SPLC risk after IPLC diagnosis using cause-specific Cox regression. We evaluated the model’s clinical utility using decision curve analysis and externally validated it using 2 population-based data—Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and National Lung Screening Trial (NLST)—that included 2963 and 2844 IPLC (101 and 93 SPLC cases), respectively.

Over 14 063 person-years, 145 (2.3%) ever-smoking IPLC patients developed SPLC in MEC. Our prediction model demonstrated a high predictive accuracy (Brier score = 2.9, 95% confidence interval [CI] = 2.4 to 3.3) and discrimination (area under the receiver operating characteristics [AUC] = 81.9%, 95% CI = 78.2% to 85.5%) based on bootstrap validation in MEC. Stratification by the estimated risk quartiles showed that the observed SPLC incidence was statistically significantly higher in the 4th vs 1st quartile (9.5% vs 0.2%; P < .001). Decision curve analysis indicated that in a wide range of 10-year risk thresholds from 1% to 20%, the model yielded a larger net-benefit vs hypothetical all-screening or no-screening scenarios. External validation using PLCO and NLST showed an AUC of 78.8% (95% CI = 74.6% to 82.9%) and 72.7% (95% CI = 67.7% to 77.7%), respectively.

We developed and validated a SPLC prediction model based on large population-based cohorts. The proposed prediction model can help identify high-risk LC patients for SPLC and can be incorporated into clinical decision making for SPLC surveillance and screening.

• Cancer screening
• Cancer surveillance
• Cancer survivors
• Lung cancer
• Risk prediction models
• Risk stratification
• Second primary lung cancer

• Disease-free interval
• Overall survival
• Prognostic factors
• Second primary lung cancer
• Type of surgery

• Screening
• Second primary lung cancer
• Smoking cessation
• Surveillance
• Tobacco smoking

• Humans
• Lung
• Lung Neoplasms/epidemiology
• Lung Neoplasms/etiology
• Male
• Neoplasms, Second Primary/epidemiology
• Neoplasms, Second Primary/etiology
• Prospective Studies
• Risk Factors
• Tobacco Smoking

• U19 CA203654 NCI NIH HHS
• P30 ES030285 NIEHS NIH HHS
• R37 CA226081 NCI NIH HHS
• 001 World Health Organization
• U01 CA164973 NCI NIH HHS

Targeted surveillance strategies following initial primary lung cancer (IPLC) treatment are currently limited. One hundred twenty patients diagnosed with IPLC who did not develop second primary lung cancer (SPLC) were matched to 121 patients who developed SPLC. Our analysis found IPLC surgical resection increases SPLC emergence risk regardless of procedure type. Increased survival after IPLC resection warrants close SPLC monitoring.

• Mortality
• Surgical resection
• Surveillance
• Survival
• Targeted monitoring

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung/pathology
• Case-Control Studies
• Female
• Humans
• Lung Neoplasms/secondary
• Male
• Middle Aged
• Neoplasms, Second Primary/etiology
• Risk Factors

• P30 CA022453 NCI NIH HHS

• Metabolomics
• Risk stratification
• Screening
• Second primary lung cancer
• Surveillance

Here, we report a thirteen years’ survivor of initial primary lung cancer, who successfully diagnosed with second primary lung cancer(SPLC). It was arising from the pneumonectomy cavity of a non-small cell lung cancer(NSCLC). Few cases of SPLC associated with the post-pneumonectomy cavity have been reported in the literature. The histologic results of SPLC was metastatic pleomorphic carcinoma. It is a rare type of lung cancer; which incidence has been reported to range from 0.1% to 0.4% among all lung cancers. Based on regular follow-up with chest computed tomography(CT) and an understanding of post-pneumonectomy changes, the second primary pleomorphic carcinoma was correctly diagnosed and appropriately treated.

• CT, computed-tomography
• IPLC, initial primary lung cancer
• Lung cancer
• MRI, magnetic resonance imaging
• NSCLC, non-small cell lung cancer
• PET, positron emission tomography
• Pleomorphic carcinoma
• Pneumonectomy
• SPLC, second primary lung cancer
• Second primary lung cancer

• competing risk
• follow-up
• lung cancer
• nomogram
• second primary cancer

• NSCLC
• Recurrence
• SABR
• SBRT
• Salvage

• Bronchial carcinoma
• Long-term follow-up
• Other malignancies
• Prognosis
• Relapse

There is conflicting evidence from the small number of randomized controlled trials (RCTs) that have assessed the benefit of survivorship care plans (SCPs) on improving patient outcomes. Yet, published quasi-experimental and descriptive studies provide preliminary evidence suggesting that using survivorship care plans in practice may improve patient knowledge, decrease worry and anxiety, and lead to patient and primary care physician satisfaction. Given the conflicting evidence and the paucity of RCTs, further research is needed to more fully explore the effect of SCP on patient outcomes. To address this knowledge gap, an SCP program was implemented in a community-based oncology clinic and used quality improvement methodology to assess the effect on patient knowledge of diagnosis, treatment, and follow-up, and to understand patients’ satisfaction with the current SCP program. A total of 30 cancer patients were recruited in Southeast Michigan to participate in an SCP quality improvement project and completed surveys to evaluate the SCP program. Data were collected between December 2017 and March 2018. We observed a statistically significant (p = .028) difference between pre- and postintervention (survivorship care plan visit) knowledge scores about cancer diagnosis, treatment received, and follow-up recommendations. Moreover, participants were satisfied with the survivorship care plan and visit.

• clinical epidemiology
• lung cancer
• non-small cell lung cancer

• Adult
• Aged
• Aged, 80 and over
• England/epidemiology
• Female
• Follow-Up Studies
• Head and Neck Neoplasms/epidemiology
• Head and Neck Neoplasms/etiology
• Humans
• Incidence
• Lung Neoplasms/epidemiology
• Lung Neoplasms/etiology
• Male
• Middle Aged
• Neoplasms, Second Primary/epidemiology
• Neoplasms, Second Primary/etiology
• Prognosis
• Retrospective Studies
• Risk Factors
• Smoking/adverse effects
• Smoking/epidemiology
• Survival Rate/trends
• Time Factors

• 18180 Cancer Research UK
• C18081/A18180 Cancer Research UK
• Cancer Research UK Cambridge Centre

• Lung neoplasm
• lung resection
• proton beam therapy

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung/pathology
• Carcinoma, Non-Small-Cell Lung/surgery
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms/pathology
• Lung Neoplasms/surgery
• Male
• Middle Aged
• Neoplasms, Second Primary/etiology
• Neoplasms, Second Primary/pathology
• Neoplasms, Second Primary/radiotherapy
• Prognosis
• Proton Therapy/mortality
• Pulmonary Surgical Procedures/adverse effects
• Retrospective Studies
• Survival Rate

In daily clinical practice, radiologists and pulmonologists are faced with incidental radiographic findings of pulmonary nodules. Deciding how to manage these findings is very important as many of them may be benign and require no further action, but others may represent early disease and importantly early-stage lung cancer and require prompt diagnosis and definitive treatment. As the diagnosis of pulmonary nodules includes invasive procedures which can be relatively minimal, such as bronchoscopy or transthoracic aspiration or biopsy, but also more invasive procedures such as thoracic surgical biopsies, and as these procedures are linked to anxiety and to cost, it is important to have clearly defined algorithms for the description, management, and follow-up of these nodules. Clear algorithms for the imaging protocols and the management of positive findings should also exist in lung cancer screening programs, which are already established in the USA and which will hopefully be established worldwide. This article reviews current knowledge on nodule definition, diagnostic evaluation, and management based on literature data and mainly recent guidelines.

• Low-dose computed tomography
• lung cancer screening
• lung nodule management
• lung nodules

This study was designed to estimate the trends in 5-year incidence of metachronous second primary lung cancer(SPLC) and to establish a risk prediction model to identify candidates who were at high risk of developing metachronous SPLC.

Incidence data between 2004 and 2007 were obtained from SEER database, including 42453 participants who survived ≥ 2 years after the initial diagnosis of lung cancer. Joinpoint regression analysis was used to calculate the 5-year incidence rates of metachronous SPLC per 100 000 population. Related risk factors of the survivors who developed MSPLC during five years were identified through logistic regression analysis, followed by establishment of risk prediction nomogram. Discrimination (C-index), calibration and decision analysis were further performed to assess the validation and clinical net benefit of risk prediction nomogram.

A total of 1412 survivors with lung cancer developed MSPLC during five years, with 3546 per 100 000 population of age-adjusted 5-year incidence. Age, histology, tumor stage, and radiation were recognized as risk factors of metachronous SPLC, as indicated by logistic regression analysis. The risk prediction nomogram of metachronous SPLC harbored moderate discrimination(C-index = 0.67) and good calibration, with the risk of 0.01 to 0.11.The decision curve analysis showed that clinical net benefit of this risk prediction nomogram in a range of risk thresholds (0.01 to 0.06) was higher compared to all-screening or no-screening strategies.

Collectively, the cumulative risk of metachronous SPLC of the survivors increased over time. The risk prediction nomogram was available to select high-risk survivors who should regularly undergo computed tomography screening.

• Aged
• Aged, 80 and over
• Cancer Survivors/statistics & numerical data
• Female
• Humans
• Incidence
• Lung Neoplasms/epidemiology
• Male
• Middle Aged
• Neoplasms, Second Primary/epidemiology
• Nomograms
• Risk Assessment

• Lung cancer
• Surveillance
• Survivor

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung/pathology
• Cohort Studies
• Combined Modality Therapy/methods
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms/pathology
• Male
• Medicare
• Neoplasm Recurrence, Local/pathology
• Neoplasm Staging/methods
• SEER Program
• Survivors
• United States

• R50 CA275877 NCI NIH HHS

• Non-small cell lung cancer (NSCLC)
• post-operative
• recurrence dynamic
• surveillance

• Adjuvant chemotherapy
• Cisplatin
• Non-small cell lung cancer
• Survival
• Vinorelbine

• clinical practice guidelines
• evidence based practice
• lung cancer
• quality of health care
• scoping review

• Evidence-Based Medicine
• Humans
• Lung Neoplasms/diagnosis
• Lung Neoplasms/therapy
• Medical Oncology
• Palliative Care
• Professional Practice Gaps
• Psycho-Oncology/standards
• Referral and Consultation/standards

Lung cancer survivors are more likely to develop colorectal and stomach cancer than the general population. However, little is known about the current status of gastrointestinal cancer screening practices and related factors among lung cancer survivors.

We enrolled 829 disease-free lung cancer survivors ≥40 years of age, who had been treated at two hospitals from 2001 to 2006. The patients completed a questionnaire that included stomach and colorectal cancer screening after lung cancer treatment, as well as other sociodemographic variables.

Among lung cancer survivors, correlations with stomach and colorectal screening recommendations were 22.7 and 25.8%, respectively. Of these, 40.7% reported receiving physician advice to screen for second primary cancer (SPC). Those who were recommended for further screening for other cancers were more likely to receive stomach cancer screening [adjusted odds ratios (aOR) = 1.63, 95% confidence interval (CI), 1.16–2.30] and colorectal cancer screening [aOR = 1.37, 95% CI, 0.99–1.90]. Less-educated lung cancer survivors were less likely to have stomach and colorectal cancer screenings.

Lack of a physician’s advice for SPC screening and lower educational status had negative impact on the gastrointestinal cancer screening rates of lung cancer survivors.

The online version of this article (10.1186/s12885-017-3583-z) contains supplementary material, which is available to authorized users.

• Colorectal cancer screening
• Lung cancer survivor
• Physician recommendation
• Stomach cancer screening

• lung cancer
• secondary malignancy
• survival

• Aged
• Carcinoma, Non-Small-Cell Lung/diagnosis
• Carcinoma, Non-Small-Cell Lung/epidemiology
• Diagnostic Imaging/methods
• Disease-Free Survival
• Female
• Humans
• Incidence
• Lung Neoplasms/diagnosis
• Lung Neoplasms/epidemiology
• Male
• Neoplasm Staging
• Neoplasms, Second Primary/diagnosis
• Neoplasms, Second Primary/epidemiology
• Prognosis
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Survival Rate/trends
• Taiwan/epidemiology

The National Lung Screening Trial (NLST) was a large, randomized, controlled study showing a 20% reduction of lung cancer mortality and 7% reduction of all cause mortality using annual low dose computed tomography (LDCT) in a high risk population. NLST excluded people with a previous history of cancer treatment within the past 5 years and all people with a history lung cancer. The aim of this work is to review how lung cancer screening trials addressed the confounding effect of previous malignancy. We also review the subsequent recommendations by the United States Preventative Task Force Services, multiple professional societies and the Center for Medicaid and Medicare Services which defer either to NLST criteria or, clinician judgment or refrain from asserting any recommendation on the topic, respectively. Implications of lung cancer screening in the setting of previous malignancies, specifically lung, head and neck, esophageal, gastric, breast, colorectal cancer and lymphoma are also discussed. With lung cancer screening, an antecedent malignancy introduces the possibility of discovering metastasis as well as lung cancer. In some circumstances diagnosis and treatment of oligometastatic disease may confer a survival benefit. The survival benefit of treating either lung cancer or oligometastatic disease as result of lung cancer screening has yet to be determined. Further studies are needed to determine the role of lung cancer screening in the setting of previous malignancy.

• Lung cancer screening
• Criteria
• Previous malignancy
• Antecedent malignancy
• Lung metastasis
• Guidelines
• Head and neck cancer
• Lung cancer
• Low dose computed tomography
• Gastric cancer
• Breast cancer
• Colorectal cancer
• Lymphoma
• Esophageal cancer