Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers

被引:131
作者
Diederich, S
Thomas, M
Semik, M
Lenzen, H
Roos, N
Weber, A
Heindel, W
Wormanns, D
机构
[1] Univ Munster, Dept Clin Radiol, D-48129 Munster, Germany
[2] Univ Munster, Dept Haematol Oncol & Resp Med, D-48129 Munster, Germany
[3] Univ Munster, Dept Thorac & Cardiovasc Surg, D-48129 Munster, Germany
关键词
lung cancer screening; pulmonary nodule; incidence results; symptom-diagnosed cancer;
D O I
10.1007/s00330-003-2200-5
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The aim of this study was analysis of incidence results in a prospective one-arm feasibility study of lung cancer screening with low-radiation-dose spiral computed tomography in heavy smokers. Eight hundred seventeen smokers (greater than or equal to40 years, greater than or equal to20 pack years of smoking history) underwent baseline low-dose CT. Biopsy was recommended in nodules >10 mm with CT morphology suggesting malignancy. In all other lesions follow-up with low-dose CT was recommended. Annual repeat CT was offered to all study participants. Six hundred sixty-eight (81.8%) of the 817 subjects underwent annual repeat CT with a total of 1735 follow-up years. Follow-up of non-calcified nodules present at baseline CT demonstrated growth in 11 of 792 subjects. Biopsy was performed in 8 of 11 growing nodules 7 of which represented lung cancer. Of 174 new nodules, 3 represented lung cancer. The 10 screen-detected lung cancers were all non-small cell cancer (6 stage IA, 1 stage IB, 1 stage IIIA, 2 stage IV). Five symptom-diagnosed cancers (2 small cell lung cancer: 1 limited disease, 1 extensive disease, 3 central/endobronchial non-small cell lung cancer, 2 stage IIIA, 1 stage IIIB) were diagnosed because of symptoms in the 12-month interval between two annual CT scans. Incidence of lung cancer was lower than prevalence, screen-detected cancers were smaller, and stage I was found in 70% (7 of 10) of screen-detected tumors. Only 27% (4 of 15) of invasive procedures was performed for benign lesions; however, 33% (5 of 15) of all cancers diagnosed in the population were symptom-diagnosed cancers (3 central NSCLC, all stage III, 2 SCLC) demonstrating the limitations of CT screening.
引用
收藏
页码:691 / 702
页数:12
相关论文
共 18 条
[1]  
*AM CANC SOC, 2001, CANC FACTS FIG
[2]   Screening for early lung cancer with low-dose spiral CT: Prevalence in 817 asymptomatic smokers [J].
Diederich, S ;
Wormanns, D ;
Semik, M ;
Thomas, M ;
Lenzen, H ;
Roos, N ;
Heindel, W .
RADIOLOGY, 2002, 222 (03) :773-781
[3]  
Henschke CI, 2001, CANCER, V92, P153, DOI 10.1002/1097-0142(20010701)92:1<153::AID-CNCR1303>3.0.CO
[4]  
2-S
[5]   Early Lung Cancer Action Project: overall design and findings from baseline screening [J].
Henschke, CI ;
McCauley, DI ;
Yankelevitz, DF ;
Naidich, DP ;
McGuinness, G ;
Miettinen, OS ;
Libby, DM ;
Pasmantier, MW ;
Koizumi, J ;
Altorki, NK ;
Smith, JP .
LANCET, 1999, 354 (9173) :99-105
[6]   Second malignancies in early stage laryngeal carcinoma patients treated with radiotherapy [J].
Holland, JM ;
Arsanjani, A ;
Liem, BJ ;
Hoffelt, SC ;
Cohen, JI ;
Stevens, KR .
JOURNAL OF LARYNGOLOGY AND OTOLOGY, 2002, 116 (03) :190-193
[7]   Peripheral lung cancer: Screening and detection with low-dose spiral CT versus radiography [J].
Kaneko, M ;
Eguchi, K ;
Ohmatsu, H ;
Kakinuma, R ;
Naruke, T ;
Suemasu, K ;
Moriyama, N .
RADIOLOGY, 1996, 201 (03) :798-802
[8]   Revisions in the International System for Staging Lung Cancer [J].
Mountain, CF .
CHEST, 1997, 111 (06) :1710-1717
[9]   Lung cancer screening using low-dose spiral CT - Results of baseline and 1-year follow-up studies [J].
Nawa, T ;
Nakagawa, T ;
Kusano, S ;
Kawasaki, Y ;
Sugawara, Y ;
Nakata, H .
CHEST, 2002, 122 (01) :15-20
[10]   Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results [J].
Pastorino, U ;
Bellomi, M ;
Landoni, C ;
De Fiori, E ;
Arnaldi, P ;
Picchio, M ;
Pelosi, G ;
Boyle, P ;
Fazio, F .
LANCET, 2003, 362 (9384) :593-597