The following is a summary of “Abdominal Noncontrast Computed Tomography Scanning to Screen for Kidney Cancer and Other Abdominal Pathology Within Community-based Computed Tomography Screening for Lung Cancer: Results of the Yorkshire Kidney Screening Trial,” published in the September 2024 issue of Urology by Stewart et al.
The Yorkshire Kidney Screening Trial (YKST) evaluated the feasibility of integrating abdominal non-contrast computed tomography (NCCT) into lung cancer screening protocols to identify kidney cancer and other abdominal pathologies. Conducted between May 2021 and October 2022, this prospective diagnostic study included ever-smokers aged 55-80 from a UK randomized lung cancer screening trial. Exclusion criteria comprised dementia, frailty, prior kidney or lung cancer, and recent CT imaging of the abdomen or thorax. A six-month follow-up was implemented to assess outcomes. Of the 4,438 individuals who attended lung screening, 4,309 (97%) were eligible for abdominal NCCT, and 4,019 (93%) accepted the additional screening. Participant satisfaction was high, with only 3.9% expressing regret. The addition of the NCCT process extended the screening time by 13.3 minutes.
Results showed that 2,586 participants (64%) had normal abdominal NCCTs, while 787 (20%) required imaging review without further action, and 611 (15%) needed additional evaluation. Serious findings were identified in 211 participants (5.3%), including 25 (0.62%) with renal masses or complex cysts, 10 (0.25%) of whom were histologically confirmed as kidney cancer, 10 (0.25%) with other cancers, and 60 (1.5%) with abdominal aortic aneurysms (AAAs). Curative treatment was administered to 25 (0.62%) participants. Non-serious findings were noted in 1,017 participants (25%), predominantly benign renal cysts (727 [18%]), with 259 (6.4%) requiring further tests.
The study calculated that 18 individuals needed to be screened to detect one serious abdominal finding, 93 for one suspicious renal lesion, and 402 for one histologically confirmed renal cancer. The study’s limitations included a fixed age range and the pre-selection of participants from a lung cancer screening cohort.
In conclusion, the integration of abdominal NCCT with lung cancer screening demonstrated high uptake and participant satisfaction, with serious finding rates comparable to established screening programs such as for bowel cancer. Further research should focus on long-term outcomes and cost-effectiveness.
Source: sciencedirect.com/science/article/pii/S0302283824025673
