Abstract
The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAseff.; 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population.
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Levi F, Lucchini F, Negri E, La Vecchia C (1999) Worldwide patterns of cancer mortality, 1990–1994. Eur J Cancer Prev 8:381–400
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics, 2003. CA Cancer J Clin 53:5–26
Alberg AJ, Brock MV, Samet JM (2005) Epidemiology of lung cancer: looking to the future. J Clin Oncol 23:3175–3185
Jemal A, Murray T, Ward E et al (2005) Cancer statistics, 2005. CA Cancer J Clin 55:10–30
Mountain CF (1997) Revisions in the international system for staging lung cancer. Chest 111:1710–1717
Shopland DR, Eyre HJ, Pechacek TF (1991) Smoking-attributable cancer mortality in 1991: is lung cancer now the leading cause of death among smokers in the United States? J Natl Cancer Inst 83:1142–1148
Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr, Doll R (1996) Mortality from smoking worldwide. Br Med Bull 52:12–21
Wramner B, Pellmer K (2002) Tobacco-related mortality following the Peto-Lopez epidemiological model used in international public health comparison. Cent Eur J Public Health 10:142–145
Kazan-Allen L (2003) The asbestos war. Int J Occup Environ Health 9:173–193
Kishimoto T, Ohnishi K, Saito Y (2003) Clinical study of asbestos-related lung cancer. Ind Health 41:94–100
Paek D (2003) Asbestos problems yet to explode in Korea. Int J Occup Environ Health 9:266–271
Kjellstrom T, Smartt P (2000) Increased mesothelioma incidence in New Zealand: the asbestos-cancer epidemic has started. N Z Med J 113:485–490
Bruske-Hohlfeld I (1999) Occupational cancer in Germany. Environ Health Perspect 107(Suppl 2):253–258
Wright JL, Tron V, Wiggs B, Churg A (1988) Cigarette smoke potentiates asbestos-induced airflow abnormalities. Exp Lung Res 14:537–548
McFadden D, Wright J, Wiggs B, Churg A (1986) Cigarette smoke increases the penetration of asbestos fibers into airway walls. Am J Pathol 123:95–99
Albin M, Magnani C, Krstev S, Rapiti E, Shefer I (1999) Asbestos and cancer: an overview of current trends in Europe. Environ Health Perspect 107(Suppl 2):289–298
Hammond EC, Selikoff IJ, Seidman H (1979) Asbestos exposure, cigarette smoking and death rates. Ann N Y Acad Sci 330:473–490
Kaneko M, Eguchi K, Ohmatsu H et al (1996) Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology 201:798–802
Henschke CI, McCauley DI, Yankelevitz DF et al (1999) Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 354:99–105
Diederich S, Wormanns D, Semik M et al (2002) Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology 222:773–781
Swensen SJ, Jett JR, Hartman TE et al (2003) Lung cancer screening with CT: Mayo Clinic experience. Radiology 226:756–761
Henschke CI, McCauley DI, Yankelevitz DF et al (2001) Early lung cancer action project: a summary of the findings on baseline screening. Oncologist 6:147–152
Henschke CI, Naidich DP, Yankelevitz DF et al (2001) Early lung cancer action project: initial findings on repeat screenings. Cancer 92:153–159
Nawa T, Nakagawa T, Kusano S, Kawasaki Y, Sugawara Y, Nakata H (2002) Lung cancer screening using low-dose spiral CT: results of baseline and 1-year follow-up studies. Chest 122:15–20
Sone S, Li F, Yang ZG et al (2001) Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer 84:25–32
Sone S, Takashima S, Li F et al (1998) Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 351:1242–1245
Sobue T, Moriyama N, Kaneko M et al (2002) Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project. J Clin Oncol 20:911–920
Tiitola M, Kivisaari L, Huuskonen MS et al (2002) Computed tomography screening for lung cancer in asbestos-exposed workers. Lung Cancer 35:17–22
Swensen SJ, Jett JR, Hartman TE et al (2005) CT screening for lung cancer: five-year prospective experience. Radiology 235:259–265
Miller A, Markowitz S, Manowitz A, Miller JA (2004) Lung cancer screening using low-dose high-resolution CT scanning in a high-risk workforce: 3500 nuclear fuel workers in three US states. Chest 125:152S–153S
Pastorino U, Bellomi M, Landoni C et al (2003) Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 362:593–597
Catalano C, Napoli A, Nardis PG, Fraioli F, Passariello R (2005) Incidental finding of lung cancer in patients studied by MDCT for atherosclerotic disease. Eur Radiol 15:2031–2033
Diederich S, Thomas M, Semik M et al (2004) Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers. Eur Radiol 14:691–702
Henschke CI, Yankelevitz DF, Kostis WJ (2003) CT screening for lung cancer. Semin Ultrasound CT MR 24:23–32
Hartman TE, Swensen SJ (2003) Lung cancer screening with low-dose computed tomography. Semin Roentgenol 38:34–38
Wormanns D, Ludwig K, Beyer F, Heindel W, Diederich S (2005) Detection of pulmonary nodules at multirow-detector CT: effectiveness of double reading to improve sensitivity at standard-dose and low-dose chest CT. Eur Radiol 15:14–22
Diederich S, Hansen J, Wormanns D (2005) Resolving small pulmonary nodules: CT features. Eur Radiol 15:2064–2069
Pistolesi M, Rusthoven J (2004) Malignant pleural mesothelioma: update, current management, and newer therapeutic strategies. Chest 126:1318–1329
Bianchi C, Giarelli L, Grandi G, Brollo A, Ramani L, Zuch C (1997) Latency periods in asbestos-related mesothelioma of the pleura. Eur J Cancer Prev 6:162–166
Berrington de Gonzalez A, Darby S (2004) Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 363:345–351
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Das, M., Mühlenbruch, G., Mahnken, A.H. et al. Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT. Eur Radiol 17, 1193–1199 (2007). https://doi.org/10.1007/s00330-006-0426-8
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DOI: https://doi.org/10.1007/s00330-006-0426-8