The Danish Randomized Lung Cancer CT Screening Trial-Overall Design and Results of the Prevalence Round

被引:331
作者
Pedersen, Jesper H. [2 ]
Ashraf, Haseem [3 ]
Dirksen, Asger [3 ]
Bach, Karen [4 ]
Hansen, Hanne [4 ]
Toennesen, Phillip [3 ]
Thorsen, Hanne [1 ]
Brodersen, John [1 ]
Skov, Birgit Guldhammer [5 ]
Dossing, Martin
Mortensen, Jann [6 ]
Richter, Klaus
Clementsen, Paul [3 ]
Seersholm, Niels [3 ]
机构
[1] Univ Copenhagen, Dept Gen Practice, Inst Publ Hlth, DK-1168 Copenhagen, Denmark
[2] Univ Copenhagen, Rigshosp, Dept Thorac Surg RT, DK-1168 Copenhagen, Denmark
[3] Gentofte Univ Hosp, Dept Resp Med, Gentofte, Denmark
[4] Gentofte Univ Hosp, Dept Radiol, Gentofte, Denmark
[5] Herlev Univ Hosp, Dept Pathol, Sect Gentofte, Herlev, Denmark
[6] Rigshosp, Dept Clin Physiol Nucl Med & PET, Copenhagen, Denmark
关键词
Lung cancer; Screening; Computed tomography; CT; Randomized clinical trial; COMPUTED-TOMOGRAPHY; CRITICAL-APPRAISAL; SPIRAL CT; PROTOCOL; NODULES;
D O I
10.1097/JTO.0b013e3181a0d98f
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. Methods: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either screening with annual low dose CT scans for 5 years or no screening. A history of cigarette smoking of at least 20 pack years was required. All participants have annual lung function tests, and questionnaires regarding health status, psychosocial consequences of screening, smoking habits, and smoking cessation. Baseline CT scans were performed in 2052 participants. Pulmonary nodules were classified according to size and morphology: (1) Nodules smaller than 5 mm and calcified (benign) nodules were tabulated, (2) Noncalcified nodules between 5 and 15 nun were rescanned after 3 months. If the nodule increased in size or was larger than 15 mm the participant was referred for diagnostic workup. Results: At baseline 179 persons showed noncalcified nodules larger than 5 mm, and most were rescanned after 3 months: The rate of false-positive diagnoses was 7.9%, and 17 individuals (0.8%) turned out to have lung cancer. Ten of these had stage I disease. Eleven of 17 lung cancers at baseline were treated surgically, eight of these by video assisted thoracic surgery resection. Conclusions: Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.
引用
收藏
页码:608 / 614
页数:7
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