PURPOSE:Low-dose multislice-CT (MSCT) detects many early-stage lung cancers with good prognosis, but whether it decreases lung cancer mortality and at which costs is yet insufficiently explored. Scope of the present study is to examine within a common European effort whether MSCT screening is capable to reduce the lung cancer mortality by at least 20 % and at which amount of undesired side effects this could be achieved. METHODS:Overall 4,052 heavy smoking men and women were recruited by a population-based approach and randomized into ascreening arm with five annual MSCT screens and an initial quit-smoking counseling, and a control arm with initial quit-smoking counseling and five annual questionnaire inquiries. RESULTS: In the first screening round, 2,029 participants received a MSCT providing 1,488 negative and 540 suspicious screens with early recalls (early recall rate 26.6 %) leading to 31 biopsies (biopsy rate 1.5 %) and 22 confirmed lung cancers (detection rate 1.1 %). Among the lung cancers, 15 were adenocarcinomas, 3 squamous cell carcinomas, one small-cell lung cancer, and 3 others, whereby 18 were in clinical stage I, one in stage II, and 3 in stage III. One interval cancer occurred. CONCLUSIONS: The indicated performance indicators fit into the range observed in comparable trials. The study continues finalizing the second screening round and for the first participants even the last screening round. The unresolved issue of the precise amount of side effects and the high early recall rate precludes currently the recommendation of MSCT as screening tool for lung cancer.
RCT Entities:
PURPOSE: Low-dose multislice-CT (MSCT) detects many early-stage lung cancers with good prognosis, but whether it decreases lung cancer mortality and at which costs is yet insufficiently explored. Scope of the present study is to examine within a common European effort whether MSCT screening is capable to reduce the lung cancer mortality by at least 20 % and at which amount of undesired side effects this could be achieved. METHODS: Overall 4,052 heavy smoking men and women were recruited by a population-based approach and randomized into a screening arm with five annual MSCT screens and an initial quit-smoking counseling, and a control arm with initial quit-smoking counseling and five annual questionnaire inquiries. RESULTS: In the first screening round, 2,029 participants received a MSCT providing 1,488 negative and 540 suspicious screens with early recalls (early recall rate 26.6 %) leading to 31 biopsies (biopsy rate 1.5 %) and 22 confirmed lung cancers (detection rate 1.1 %). Among the lung cancers, 15 were adenocarcinomas, 3 squamous cell carcinomas, one small-cell lung cancer, and 3 others, whereby 18 were in clinical stage I, one in stage II, and 3 in stage III. One interval cancer occurred. CONCLUSIONS: The indicated performance indicators fit into the range observed in comparable trials. The study continues finalizing the second screening round and for the first participants even the last screening round. The unresolved issue of the precise amount of side effects and the high early recall rate precludes currently the recommendation of MSCT as screening tool for lung cancer.
Authors: C I Henschke; D I McCauley; D F Yankelevitz; D P Naidich; G McGuinness; O S Miettinen; D M Libby; M W Pasmantier; J Koizumi; N K Altorki; J P Smith Journal: Lancet Date: 1999-07-10 Impact factor: 79.321
Authors: Rob J van Klaveren; Matthijs Oudkerk; Mathias Prokop; Ernst T Scholten; Kristiaan Nackaerts; Rene Vernhout; Carola A van Iersel; Karien A M van den Bergh; Susan van 't Westeinde; Carlijn van der Aalst; Erik Thunnissen; Dong Ming Xu; Ying Wang; Yingru Zhao; Hester A Gietema; Bart-Jan de Hoop; Harry J M Groen; Geertruida H de Bock; Peter van Ooijen; Carla Weenink; Johny Verschakelen; Jan-Willem J Lammers; Wim Timens; Dik Willebrand; Aryan Vink; Willem Mali; Harry J de Koning Journal: N Engl J Med Date: 2009-12-03 Impact factor: 91.245
Authors: Stefan Diederich; Michael Thomas; Michael Semik; Horst Lenzen; Nikolaus Roos; Anushe Weber; Walter Heindel; Dag Wormanns Journal: Eur Radiol Date: 2004-01-16 Impact factor: 5.315
Authors: Peter B Bach; James R Jett; Ugo Pastorino; Melvyn S Tockman; Stephen J Swensen; Colin B Begg Journal: JAMA Date: 2007-03-07 Impact factor: 56.272
Authors: M Bade; V Bähr; U Brandt; A Eigentopf; T Brüchert; M-L Gross; E Motsch; N Becker Journal: J Cancer Res Clin Oncol Date: 2016-01-27 Impact factor: 4.553