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; rmacredmond{at}rcsi.ie
- Received 16 November 2004
- Accepted 15 April 2005
Abstract
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
Footnotes
-
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.
