Based on maximum likelihood estimators the problem of setting confidence limits for the scale and shape parameters of the Weibull distribution with two parameters is considered. Approximation formulae for the determination of sample sizes for the parameter estimation are given for complete and type II censored samples.
Abstract Background: Lung cancer is the deadliest cancer in the US. In 2022, it is anticipated that there will be 236,740 new cases and 130,180 deaths due to lung cancer in the US. Lung cancer's high mortality rate is largely due to the fact that 5.8% of eligible Americans have been screened for lung cancer, resulting in most diagnoses of lung cancer being made in late stages. As of 2020, the age-adjusted mortality rate of Winnebago and Ogle County is 26% and 40% higher than the national rate respectively. Low dose computed tomography (LDCT) is a common lung cancer screening tool utilized in clinical settings. However, minority communities have been underrepresented in the National Lung Cancer Screening Trial (90.9% white, 4.5% African American, and 1.8% Hispanic). These numbers indicate an urgent need for increased efforts to bring awareness of lung cancer risk factors and screening options to minority communities. Hypothesis/Aim: Our aim is to promote LDCT screening in Northern Illinois, particularly in minority communities that will lead to an increase in the detection of lung cancer in early stages and improve their 5-year survival. Study Design: This project educated the community through seminars and booths at local events to promote LDCT screening in our community. We utilized the U.S. Preventive Services Task Force guidelines to spread information to both community members and physicians in Winnebago County. We evaluated the number of LDCT screenings in Winnebago County from June 2015 to October 2021, and recorded the stages of lung cancer cases detected. We also evaluated the demographics and zip codes of the people we reached to determine their location and our efficacy in reaching minority communities. Results: 19 seminars and 48 public awareness booths targeting an estimated 310 physicians and 2,159 community members were conducted to increase knowledge of LDCT screening. 4,557 patients underwent LDCT screening at local hospitals during the timeframe of our study. 1.77% of smokers screened in Northern Illinois were diagnosed with lung cancer in comparison with 0.87% in the NLCST. 81 patients were diagnosed with lung cancer, with 49 cases being early stage. 1,471 individuals were found to have small lung nodules and are receiving follow up care. Before LDCT screening promotion the percentage of lung cancer cases detected in early stages was 30%. After LDCT screening promotion, the percentage was 40%. In the last six months, we have reached 609 total people (17.4% black, 53.2% Hispanic, 28.4% white, and 1% other ethnicities). We were able to localize the majority of people reached to Winnebago county zip codes. Conclusion: 49 local community members were diagnosed with early-stage lung cancer, improving their prognosis. Our promotional screening efforts have informed a higher percentage of minority groups and has increased early stage diagnoses compared to the NLCST with an increased lung cancer detection rate. Citation Format: Jacob Barnard, Emma Harper, Edgar Lopez, Jose Lopez, Iftekhar Ahmad, Joseph Ross, Sandra Martell, William Schulz, Neelu Puri. Promotion of LDCT screening in Northern Illinois with focus on minority communities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1981.
Tissue-based comprehensive genomic profiling (CGP) is increasingly used for treatment selection in patients with advanced cancer; however, tissue availability may limit widespread implementation. Here, we established real-world CGP tissue availability and assessed CGP performance on consecutively received samples.
Abstract In lung cancer, 81% of patients detected are late-stage, since early-stage patients are generally asymptomatic. Winnebago County has a 14% higher mortality rate for lung cancer when compared to the national rate; hence, to improve early detection of lung cancer in the Winnebago County, we implemented low-dose computed tomography (LDCT) screening. Currently, LDCT is used to detect lung cancer at early-stages, and the CDC has proposed new guidelines for early screening of lung cancer in individuals between 55-77 years of age with a 30 pack/year smoking history. Using circulating DNA from lung cancer patients and examining changes in methylation patterns in genes that are expressed in lung cancer patients can be used for early detection. Epidermal growth factor receptor (EGFR) is shown to be expressed in lung cancer patients’ serum in all stages; hence, it can be used as a potential biomarker for early detection. To improve early detection of lung cancer in the Winnebago County, we educated physicians/smokers about LDCT screenings to promote early detection of lung cancer. We evaluated the number of LDCTs performed and recorded the number of lung cancer cases detected in the Winnebago County between June 2015 to October 2017. To explore EGFR as a promising biomarker, plasma was separated from whole blood and collected. Circulating DNA was extracted with the MagMax cell-free circulating kit and bisulfite converted. Identification of percent methylation patterns in the EGFR promoter region in CpG islands was obtained after next generation sequencing (NGS) followed by bioinformatics analysis. In our study, 1,116 LDCT screenings occurred in the Winnebago County. Lung cancer was diagnosed in 19 patients, out of which 11 patients (57.8%) were early-stage patients. We detected 45.4% of patients screened that were present with nodules compared to 24.2% of patients in the National Lung Cancer Screening Trial. We observed that 1.70% of patients referred for LDCT screening were diagnosed with lung cancer, compared to 0.87% of patients in the National Lung Cancer Screening Trial. This may be due to the higher incidence of smoking in Winnebago County (18%) compared to the nation (15.5%). Our screening study had 96.3% false positives, which is comparable (96.4%) to the results obtained in the National Lung Cancer Screening Trial. Using NGS, methylation in the promoter region of EGFR was studied using degenerate EGFR primers. In the promoter region of EGFR, our analysis showed that there are regions of hypermethylation (68-86%) in three CpG islands in sequences at the beginning of the promoter (8-241 bases). However, there was hypomethylation (6-21%) at four CpG island further downstream (375-689 bases from the beginning of the promoter). Currently we are studying the methylation patterns in normal subjects to determine whether these regions which could be used as predictive biomarkers for early detection. Citation Format: Adijan Kuckovic, Joseph Berei, Shylendra Sreenivasappa, Joseph Ross, Sandra Martell, Connie Vitali, William Schulz, Neelu Puri. Lung cancer screening initiative and identification of novel blood biomarkers for early detection of lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3329.
