[Preliminary specification of X-ray CT for lung cancer screening (LSCT) and its evaluation on risk-cost-effectiveness].

In Japan mass screening for lung cancer is widely performed by chest X-ray film of 10 x 10 cm, with sputum cytology for high-risk groups. However, the effectiveness of the present mass screening program for lung cancer has been less than expected, although some date have shown improvement of the survival rate as a result of mass screening. We propose a new X-ray CT method of screening for lung cancer called Lung Cancer Screening CT (LSCT). The preliminary specifications for LSCT are as follows: scan speed is within 10 sec for a 40 cm length with a 1 cm slice thickness, and the absorption dose for lung is less than 1 cGy. A computer-assisted diagnostic system is necessary for image reading. The risk-benefit analysis of LSCT indicates that Japanese men and women over 45 years old can be screened in 1992 and thereafter. The cost per person.year of LSCT screening is estimated to be 1.4 x 10(6) yen for a population incidence rate of 50 x 10(-5) person/year and average life expectancy of 30 years. In 1992 the above condition will be satisfied by men aged 55 years old and above, but not by women of any age. We believe that LSCT should be developed further and tested in the high-risk group of men with an incidence rate of 100 x 10(-5) persons/year or more.