ecancermedicalscience

Research

Long-term outcomes of a pilot CT screening for lung cancer

13 May 2010
G Veronesi, P Maisonneuve, L Spaggiari, C Rampinelli, G Pelosi, L Preda, F Petrella, A Borri, M Casiraghi, R Bertolotti, N Rotmensz, M Bellomi

Background: Low-dose computed tomography (CT) screening can detect early stage lung cancer in high-risk populations. However, no data on repeated annual screening over more than 5 years are available, and the impact of screening on lung cancer mortality is controversial.

Methods: We analysed outcomes in high-risk asymptomatic volunteers (smokers and former smokers, >50 years) enrolled in a pilot study over 1 year from June 2000, who received annual low-dose CT for 7 years. Cumulative lung cancer incidence and survival were represented by KaplanMeier curves. Standardized incidence and mortality ratios were used to estimate risks relative to the general Italian and US population.

Results: Compliance was 86% at the end of the seventh year in 1035 recruited volunteers (71% men, mean age 58 years). Lung cancer was diagnosed in 54 (5.3%); radical surgery was possible in 48/54 (87%); 39/54 (72%) had stage I disease. Five-year survival was 63% overall, 89% for stage I cases. During 6308 person-years of observation, 47 participants had died versus 75 expected in the Italian general population standardised for age and sex. Fourteen lung cancer deaths were registered versus 27 expected in a standardised US smoker population.

Conclusions: Seventy percent of screening-diagnosed patients had stage I disease, and the survival of screen-detected cancer patients was high. Lung cancer mortality was favourable compared to age- and sex-matched population of US smokers, suggesting that mortality can be lowered by screening, although larger trials with longer follow-up are necessary to confirm these findings.

Related Articles

Omolara Aminat Fatiregun, Yetunde Kuyinu, Adewunmi Alabi, Anthonia Sowunmi, Okunuga Ndidi, Popoola O Abiodun, Temitope Olatunji-Agunbiade, Oyekan Ademola, Nnodimele Onuigbo Atulomah, Awotayo Olajumoke
Francis Okongo, Catherine Amuge, Alfred Jatho, Nixon Niyonzima, David Martin Ogwang, Jackson Orem
Gonzalo Javier Ziegler-Rodriguez, Miguel Ángel Pinillos Portella, Gabriel De la Cruz Ku, Sheila Eunice Vílchez Santillan, Jorge Dunstan Yataco, José Antonio Galarreta Zegarra, Gabriela Calderón Valencia, José Manuel Cotrina Concha
Norma Dewi Suryani, Juan Adrian Wiranata, Herindita Puspitaningtyas, Susanna Hilda Hutajulu, Yayi Suryo Prabandari, Adeodatus Yuda Handaya, Mardiah Suci Hardianti, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda, Ibnu Purwanto
Ghazal Tansir, Sameer Rastogi, Ekta Dhamija, Shamim Ahmed Shamim, Deepali Jain, Adarsh Barwad, Sunil Kumar, Rambha Pandey