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
- 1Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- 2Department of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
- 3Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Correspondence to:
Dr R E MacRedmond
Department of Medicine, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland;
- Received 16 November 2004
- Accepted 15 April 2005
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.
- FNAB, fine needle aspiration biopsy
- LDCCT, low dose chest computed tomography
- NCN, non-calcified nodule
- NSCLC, non-small cell lung cancer
This study was conducted in the Clinical Research Centre, Beaumont Hospital and funded in part by the Higher Education Authority, Ireland.
The PALCAD investigators comprise the authors and Dr E Kay, Professor M Leader, Dr P Broe, Professor C Kelly, Dr L Grogan, Professor S O’Neill and Professor NG McElvaney.