LUNG CANCER

Screening for lung cancer using low dose CT scanning: results of 2 year follow up

R MacRedmond¹, G McVey¹, M Lee², R W Costello¹, D Kenny³, C Foley³, P M Logan² on behalf of the PALCAD investigators

¹ Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
² Department of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
³ Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland

Correspondence to:
Correspondence to:
Dr R E MacRedmond
Department of Medicine, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland; rmacredmond{at}rcsi.ie

Background: Screening with low dose chest computed tomographic scanning (LDCCT) may improve survival by identifying early asymptomatic lung cancer.

Methods: Four hundred and forty nine high risk subjects were screened with serial LDCCT scanning over 2 years. Fine needle aspiration biopsy was recommended for non-calcified nodules (NCNs) of >10 mm diameter or demonstrating interval growth.

Results: NCNs were identified in 111 subjects (24.7%), three of which were lung cancer. The overall prevalence (0.4%) and incidence (1.3%) rates of lung cancer detection were low. Three of the six lung cancers detected in the study were stage 1 non-small cell lung cancer; the remainder were unresectable central tumours. By contrast, eight subjects developed extrathoracic malignancy during the study period and other incidental pathology was noted in 221 subjects (49.2%). Smoking cessation rates at 19% were higher than in the general population, but 60.8% of subjects continued to smoke.

Conclusion: LDCCT scanning is useful in detecting early peripheral non-small cell lung cancers but its usefulness as a screening tool is limited by low specificity and by poor sensitivity for central tumours.

Abbreviations: FNAB, fine needle aspiration biopsy; LDCCT, low dose chest computed tomography; NCN, non-calcified nodule; NSCLC, non-small cell lung cancer

Keywords: smoking; lung cancer; screening; low dose CT scanning

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2006 61: 1. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Bulk, E., Hascher, A., Liersch, R., Mesters, R. M., Diederichs, S., Sargin, B., Gerke, V., Hotfilder, M., Vormoor, J., Berdel, W. E., Serve, H., Muller-Tidow, C. (2008). Adjuvant Therapy with Small Hairpin RNA Interference Prevents Non-Small Cell Lung Cancer Metastasis Development in Mice. Cancer Res. 68: 1896-1904 [Abstract] [Full Text]  
• Ravenel, J. G., Costello, P., Silvestri, G. A. (2008). Screening for Lung Cancer. Am. J. Roentgenol. 190: 755-761 [Abstract] [Full Text]  
• Chapman, C J, Murray, A, McElveen, J E, Sahin, U, Luxemburger, U, Tureci, O, Wiewrodt, R, Barnes, A C, Robertson, J F (2008). Autoantibodies in lung cancer: possibilities for early detection and subsequent cure. Thorax 63: 228-233 [Abstract] [Full Text]  
• Lobrano, M. B. (2006). Partnerships in Oncology and Radiology: The Role of Radiology in the Detection, Staging, and Follow-up of Lung Cancer. The Oncologist 11: 774-779 [Abstract] [Full Text]  
• Karadi, R L (2006). Radiation risk of screening with low dose CT.. Thorax 61: 548-548 [Full Text]  
• Gleeson, F V (2006). Is screening for lung cancer using low dose spiral CT scanning worthwhile?. Thorax 61: 5-7 [Full Text]  

eLetters:

Read all eLetters

Screening with low dose CT Scan: Is there a radiation risk?

Rangaprasad L Karadi

Thorax Online, 23 Jan 2006 [Full text]