3 months in group 2 and 8.6 months in group 1 (Tables 3 and 4). Twenty-six percent of participants in our high-risk clinical CT lung screening program did not meet group 1 inclusion criteria and qualified for screening through group 2 (Table 1, Fig. 2). Applied nationwide, a group 2 rate of 26% would equate to approximately 2 million Americans at high risk for lung cancer outside the entry criteria of the NLST

[6]. Additionally, as nearly one-third of our group 2 population failed to meet group 1 criteria solely because they quit smoking >15 years previously, 600,000 former smokers between 55 and 74 of age with >30-pack-year smoking histories could lose access to screening Cyclopamine datasheet with national eligibility limited to group 1. Enrolling group 2 individuals does require additional provider and insurer infrastructure to assess risk factors beyond age and smoking history. To efficiently manage intake resources required in our clinical CT lung screening program, once a candidate was found to have a qualifying

risk factor for group 2, the presence of additional risk factors was not formally assessed. As such, it is possible that the order in which risk factors were assessed during the enrollment process may have influenced the breakdown of qualifying risk factors in our group 2 population. Future research is needed to comprehensively address the presence MK2206 of additional risk factors in this group. To be considered for screening, patients were required to be asymptomatic and were instructed in writing and verbally at multiple points to forgo screening for 12 weeks after clinical symptoms of pulmonary

infection had resolved. Despite these focused efforts, 6.5% of patients had radiographic evidence of evolving or resolving infection on their screening examinations, with similar frequencies in groups 1 and 2. Our rate of clinically significant incidental findings was also nearly identical for group 1 and group 2 at approximately 6.0% and was significantly less than the 10.2% reported on the prevalence screen in the NLST [6]. This difference may be explained by the fact that approximately 20% of our screened patients had prior cross-sectional imaging of at least part of the chest available for review at time of examination interpretation or that some cases of suspected infection were included in this category OSBPL9 in the NLST. The overall average age and smoking history of group 2 in our study cohort were slightly lower than those of group 1, with a more notable difference in duration of smoking cessation among former smokers in each group (18.5 years in group 2 vs 6.7 years in group 1) (Table 1). Despite these statistically significant differences in age, smoking history, and smoking cessation characteristics, there was no statistically significant difference in the rate of positive results between group 2 and group 1, and the positive rates are similar to those reported on the prevalence screen in the NLST [11].