{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:11:26Z","timestamp":1788495086299,"version":"build-2803163510"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi250981-4\"><jats:title>Importance<\/jats:title><jats:p>Cancer survivorship in the US is increasing greatly, and cancer survivors are at increased risk of developing second primary cancers, with lung cancer being the most common. However, data on lung cancer screening (LCS) with low-dose computed tomography (LDCT) in cancer survivors are lacking.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-5\"><jats:title>Objective<\/jats:title><jats:p>To compare characteristics, LDCT interpretation, lung cancer detection rate (CDR), and all-cause mortality rate among cancer survivors vs individuals without prior cancer undergoing LCS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study used North Carolina Lung Screening Registry (NCLSR) data from 2015 to 2019 among individuals undergoing LCS at 8 sites in North Carolina. The NCLSR was linked with the North Carolina Central Cancer Registry from 2000 to 2020 to identify cancer survivors and individuals without prior cancer. Data analysis was performed from June 2024 to April 2025.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-7\"><jats:title>Exposure<\/jats:title><jats:p>Undergoing LCS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was whether lung cancer was diagnosed within 1 year after the first LCS examination. Comparison of demographic characteristics between cancer survivors and those without prior cancer was performed with \u03c7<jats:sup>2<\/jats:sup> tests. The association of previous cancer with LDCT interpretation, lung CDR, and all-cause mortality rate was modeled using logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-9\"><jats:title>Results<\/jats:title><jats:p>Of a total of 7295 individuals (mean [SD] age, 64.71 [6.34] years), 814 were cancer survivors (425 men [52.2%]), and 6481 (3290 men [50.8%]) had no history of cancer. Compared with the individuals without prior cancer, cancer survivors were older (3267 individuals without prior cancer [50.4%] vs 501 cancer survivors [61.6%] were aged \u226565 years; \u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u2009=\u200935.93; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001), were more likely to be Black than White or other races (871 individuals without prior cancer [13.4%] vs 137 cancer survivors [16.8%] were Black; \u03c7<jats:sup>2<\/jats:sup><jats:sub>2<\/jats:sub>\u2009=\u200912.46; <jats:italic>P<\/jats:italic>\u2009=\u2009.002), were more likely to have formerly vs currently smoked (2728 individuals without prior cancer [42.7%] vs 418 cancer survivors [51.9%] formerly smoked; \u03c7<jats:sup>2<\/jats:sup><jats:sub>2<\/jats:sub>\u2009=\u200924.62; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001), and had higher rates of respiratory comorbidities (1834 individuals without prior cancer [35.0%] vs 268 cancer survivors [39.9%]; \u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u2009=\u20096.19; <jats:italic>P<\/jats:italic>\u2009=\u2009.01) and cardiovascular comorbidities (3043 individuals without prior cancer [58.1%] vs 432 cancer survivors [64.4%]; \u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u2009=\u20099.70; <jats:italic>P<\/jats:italic>\u2009=\u2009.002). Cancer survivors and those without prior cancer had similar adjusted rates of positive LDCT results (120 of 758 cancer survivors [15.8%] vs 1032 of 6059 individuals without prior cancer [17.0%]; \u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u2009=\u20090.86; <jats:italic>P<\/jats:italic>\u2009=\u2009.35). The adjusted lung CDRs were 26.0 cases per 1000 (95% CI, 17.0-38.2 cases per 1000) among cancer survivors vs 17.0 cases per 1000 (95% CI, 14.1-20.6 cases per 1000) among those without prior cancer (\u03c7<jats:sup>2<\/jats:sup><jats:sub>1<\/jats:sub>\u2009=\u20093.38; <jats:italic>P<\/jats:italic>\u2009=\u2009.07); the all-cause mortality rates were 19.4 cases per 1000 (95% CI, 12.0-31.3 cases per 1000) among cancer survivors vs 17.1 cases per 1000 (95% CI, 14.1-20.6 cases per 1000) among those without prior cancer (\u03c7<jats:sup>2<\/jats:sup><jats:sub>2<\/jats:sub>\u2009=\u20090.25; <jats:italic>P<\/jats:italic>\u2009=\u2009.62).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi250981-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study of LCS-screened individuals, cancer survivors were more likely to be older and formerly smoked and had slightly more comorbidities compared with individuals without prior cancer. Although rates of positive LDCT findings were similar, these findings suggest that the lung CDR may be higher in cancer survivors vs those without prior cancer and should be evaluated in larger studies. The complex relationship between cancer survivorship and the risk of second primary lung cancer underscores both the challenges and the opportunities for preventive care, such as LCS, in this population.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.35000","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:30:30Z","timestamp":1759246230000},"page":"e2535000","source":"Crossref","is-referenced-by-count":1,"title":["Lung Cancer Screening in Cancer Survivors vs Those Without a History of Cancer"],"prefix":"10.1001","volume":"8","author":[{"given":"M. Patricia","family":"Rivera","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, The University of Rochester Medical Center, Rochester, New York"},{"name":"Wilmot Cancer Institute, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thad","family":"Benefield","sequence":"additional","affiliation":[{"name":"Department of Radiology, The University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle D.","family":"Durham","sequence":"additional","affiliation":[{"name":"Department of Radiology, The University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay M.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Radiology, The University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Fiscella","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, The University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya","family":"Mohile","sequence":"additional","affiliation":[{"name":"Wilmot Cancer Institute, University of Rochester, Rochester, New York"},{"name":"Department of Medicine, Division of Hematology and Oncology, The University of Rochester Medical Center, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise M.","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Radiology, The University of North Carolina, Chapel Hill"},{"name":"Lineberger Comprehensive Cancer Center, The University of North Carolina, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"issue":"11","key":"zoi250981r2","doi-asserted-by":"publisher","first-page":"1784","DOI":"10.1093\/jnci\/djae135","article-title":"Prevalence of cancer survivors in the United States.","volume":"116","author":"Tonorezos","year":"2024","journal-title":"J Natl Cancer Inst"},{"issue":"7","key":"zoi250981r3","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1158\/1055-9965.EPI-16-0133","article-title":"Anticipating the \u201csilver tsunami\u201d: prevalence trajectories and comorbidity burden among older cancer survivors in the United States.","volume":"25","author":"Bluethmann","year":"2016","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"19","key":"zoi250981r4","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1200\/JCO.21.00226","article-title":"Survivorship care of older adults with cancer: priority areas for clinical practice, training, research, and policy.","volume":"39","author":"Kent","year":"2021","journal-title":"J Clin Oncol"},{"issue":"1","key":"zoi250981r5","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/S1470-2045(23)00538-7","article-title":"Cumulative incidence of second primary cancers in a large nationwide cohort of Danish cancer survivors: a population-based retrospective cohort study.","volume":"25","author":"Kjaer","year":"2024","journal-title":"Lancet Oncol"},{"issue":"24","key":"zoi250981r6","doi-asserted-by":"publisher","first-page":"2521","DOI":"10.1001\/jama.2020.23130","article-title":"Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in the United States.","volume":"324","author":"Sung","year":"2020","journal-title":"JAMA"},{"issue":"5","key":"zoi250981r7","doi-asserted-by":"publisher","first-page":"330","DOI":"10.7326\/M13-2771","article-title":"Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement.","volume":"160","author":"Moyer","year":"2014","journal-title":"Ann Intern Med"},{"issue":"10","key":"zoi250981r8","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1001\/jama.2021.1117","article-title":"Screening for lung cancer: US Preventive Services Task Force recommendation statement.","volume":"325","author":"Krist","year":"2021","journal-title":"JAMA"},{"issue":"5","key":"zoi250981r9","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa1102873","article-title":"Reduced lung-cancer mortality with low-dose computed tomographic screening.","volume":"365","author":"Aberle","year":"2011","journal-title":"N Engl J Med"},{"issue":"6","key":"zoi250981r10","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1056\/NEJMoa1911793","article-title":"Reduced lung-cancer mortality with volume CT screening in a randomized trial.","volume":"382","author":"de Koning","year":"2020","journal-title":"N Engl J Med"},{"issue":"4","key":"zoi250981r11","doi-asserted-by":"publisher","first-page":"412","DOI":"10.6004\/jnccn.2018.0020","article-title":"Lung cancer screening, version 3. 2018, NCCN clinical practice guidelines in oncology.","volume":"16","author":"Wood","year":"2018","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"zoi250981r12","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.jtcvs.2012.05.060","article-title":"The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups.","volume":"144","author":"Jaklitsch","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"11","key":"zoi250981r14","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1093\/jnci\/djae141","article-title":"Comparing characteristics of individuals screened for lung cancer with 2021 vs 2013 US Preventive Services Task Force recommendations.","volume":"116","author":"Henderson","year":"2024","journal-title":"J Natl Cancer Inst"},{"issue":"21","key":"zoi250981r18","doi-asserted-by":"publisher","first-page":"2300","DOI":"10.1001\/jama.2016.6255","article-title":"Development and validation of risk models to select ever-smokers for CT lung cancer screening.","volume":"315","author":"Katki","year":"2016","journal-title":"JAMA"},{"issue":"9","key":"zoi250981r19","doi-asserted-by":"publisher","first-page":"623","DOI":"10.7326\/M19-1263","article-title":"Life-gained-based versus risk-based selection of smokers for lung cancer screening.","volume":"171","author":"Cheung","year":"2019","journal-title":"Ann Intern Med"},{"issue":"6","key":"zoi250981r21","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.jtho.2021.02.003","article-title":"Lung cancer screening with low dose computed tomography in patients with and without prior history of cancer in the National Lung Screening Trial.","volume":"16","author":"Henderson","year":"2021","journal-title":"J Thorac Oncol"},{"issue":"1","key":"zoi250981r22","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1007\/s00330-020-07026-x","article-title":"Lung cancer screening in patients with previous malignancy: is this cohort at increased risk for malignancy?","volume":"31","author":"O\u2019Dwyer","year":"2021","journal-title":"Eur Radiol"},{"issue":"19","key":"zoi250981r23","doi-asserted-by":"publisher","first-page":"3075","DOI":"10.1002\/cncr.30164","article-title":"Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008.","volume":"122","author":"Donin","year":"2016","journal-title":"Cancer"},{"issue":"11","key":"zoi250981r24","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1016\/j.jtho.2021.07.001","article-title":"Risk and influencing factors for subsequent primary lung cancer after treatment of breast cancer: a systematic review and two meta-analyses based on four million cases.","volume":"16","author":"Wang","year":"2021","journal-title":"J Thorac Oncol"},{"issue":"4","key":"zoi250981r25","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1007\/s11764-024-01589-0","article-title":"A scoping review evaluating physical and cognitive functional outcomes in cancer survivors treated with chemotherapy: charting progress since the 2018 NCI think tank on cancer and aging phenotypes.","volume":"18","author":"Mohamed","year":"2024","journal-title":"J Cancer Surviv"},{"issue":"2","key":"zoi250981r26","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1093\/jnci\/djaa060","article-title":"Strategies to prevent or remediate cancer and treatment-related aging.","volume":"113","author":"Guida","year":"2021","journal-title":"J Natl Cancer Inst"},{"key":"zoi250981r27","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.lungcan.2016.05.029","article-title":"Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.","volume":"98","author":"Laccetti","year":"2016","journal-title":"Lung Cancer"},{"key":"zoi250981r1","unstructured":"National Cancer Institute. Cancer statistics. Accessed December 15, 2024. https:\/\/www.cancer.gov\/about-cancer\/understanding\/statistics"},{"key":"zoi250981r13","unstructured":"Code of Federal Regulations. 45 CFR 46.116\u2014General requirements for informed consent. Accessed September 2, 2025. https:\/\/www.ecfr.gov\/current\/title-45\/subtitle-A\/subchapter-A\/part-46\/subpart-A\/section-46.116"},{"key":"zoi250981r15","unstructured":"American College of Radiology. Lung-RADS: lung CT screening reporting and data system. Accessed January 5 2025. https:\/\/www.acr.org\/Clinical-Resources\/Clinical-Tools-and-Reference\/Reporting-and-Data-Systems\/Lung-RADS"},{"key":"zoi250981r16","unstructured":"National Cancer Institute, Division of Cancer Epidemiology & Genetics. Lung cancer models (lcmodels) R package. June 5, 2024. Accessed November 1, 2024. https:\/\/dceg.cancer.gov\/tools\/risk-assessment\/lcmodels"},{"key":"zoi250981r17","unstructured":"National Cancer Institute, Division of Cancer Epidemiology & Genetics. Lung cancer risk models for screening (R package: lcrisks). Accessed November 1, 2024. https:\/\/dceg.cancer.gov\/tools\/risk-assessment\/lcrisks"},{"key":"zoi250981r20","unstructured":"National Center for Health Statistics. National Health Interview Survey. Accessed November 1, 2024. https:\/\/www.cdc.gov\/nchs\/nhis\/index.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2839476\/rivera_2025_oi_250981_1758638220.5328.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:30:35Z","timestamp":1759246235000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2839476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.35000","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}