Long-term prognosis of patients with lung cancer detected on low-dose chest computed tomography screening

Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Fukai, Shimao; Endo, Katsuyuki

doi:10.1016/j.lungcan.2011.07.002

Cited by 26 publications

(22 citation statements)

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“…Protective effect of the CT screening on lung cancer mortality was also supported from a prognostic investigation of patients with lung cancer detected on CT screening in the US [8]. Similarly, we previously reported an excellent long-term survival of patients with lung cancer detected on the CT screening in Hitachi area [7]. Lung cancer mortality in a cohort of smokers who received CT screening for lung cancer in New York State was compared with two unscreened cohorts (CPS-II and CARET), with adjustment for age, sex, and smoking history [9].…”

Section: Discussionmentioning

confidence: 64%

“…In Hitachi Medical Center (Hitachi) also initiated chest CT screening for lung cancer for community dwellers aged 50 years or older in 2001. Details of the screening procedure, the numbers of participants and patients with lung cancer, and clinical features of screen-detected cases in each facility have been described elsewhere [5][6][7]. Table 1 shows the number of participants of the chest CT screening by sex and age as of March 2009.…”

Section: Methodsmentioning

confidence: 99%

“…Using data from a follow-up survey of 210 patients with lung cancer, 85% of which were on stage IA, detected on CT screening at Hitachi Medical Center and Hitachi Health Care Center, we reported an excellent survival (5-year survival of 90%) of these patients [7]. As of March 2006, nearly 30% of Hitachi citizens aged 50-69 is estimated to have received at least one CT lung cancer screening at either of the two medical facilities [7]. It would thus be of interest Table 1 The number of participants in low-dose chest CT screening in the two facilities a in Hitachi, Japan (as of March 2009).…”

Section: Introductionmentioning

confidence: 98%

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A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan

et al. 2012

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Section: Discussionmentioning

confidence: 64%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan

et al. 2012

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“…With respect to post-treatment survival of screen-detected cancers, the principal source remains the US ELCAP, which reported 92% 10-year survival for patients in which operable stage 1 tumours were identified, and 80% survival for all cancers detected and treated. 115 A Japanese programme 116 reported 90% 5-year survival for all screen-detected cancers, with 97% for those detected at stage 1. An earlier mobile programme in Japan 117 reported 10-year survival at 88% for stage 1 and 50% for cancers at more advanced stages.…”

Section: Age- Gender-and Stage-specific Survivalmentioning

confidence: 99%

The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer

Field

Duffy

Baldwin

et al. 2016

Health Technol Assess

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BackgroundLung cancer kills more people than any other cancer in the UK (5-year survival < 13%). Early diagnosis can save lives. The USA-based National Lung Cancer Screening Trial reported a 20% relative reduction in lung cancer mortality and 6.7% all-cause mortality in low-dose computed tomography (LDCT)-screened subjects.ObjectivesTo (1) analyse LDCT lung cancer screening in a high-risk UK population, determine optimum recruitment, screening, reading and care pathway strategies; and (2) assess the psychological consequences and the health-economic implications of screening.DesignA pilot randomised controlled trial comparing intervention with usual care. A population-based risk questionnaire identified individuals who were at high risk of developing lung cancer (≥ 5% over 5 years).SettingThoracic centres with expertise in lung cancer imaging, respiratory medicine, pathology and surgery: Liverpool Heart & Chest Hospital, Merseyside, and Papworth Hospital, Cambridgeshire.ParticipantsIndividuals aged 50–75 years, at high risk of lung cancer, in the primary care trusts adjacent to the centres.InterventionsA thoracic LDCT scan. Follow-up computed tomography (CT) scans as per protocol. Referral to multidisciplinary team clinics was determined by nodule size criteria.Main outcome measuresPopulation-based recruitment based on risk stratification; management of the trial through web-based database; optimal characteristics of CT scan readers (radiologists vs. radiographers); characterisation of CT-detected nodules utilising volumetric analysis; prevalence of lung cancer at baseline; sociodemographic factors affecting participation; psychosocial measures (cancer distress, anxiety, depression, decision satisfaction); and cost-effectiveness modelling.ResultsA total of 247,354 individuals were approached to take part in the trial; 30.7% responded positively to the screening invitation. Recruitment of participants resulted in 2028 in the CT arm and 2027 in the control arm. A total of 1994 participants underwent CT scanning: 42 participants (2.1%) were diagnosed with lung cancer; 36 out of 42 (85.7%) of the screen-detected cancers were identified as stage 1 or 2, and 35 (83.3%) underwent surgical resection as their primary treatment. Lung cancer was more common in the lowest socioeconomic group. Short-term adverse psychosocial consequences were observed in participants who were randomised to the intervention arm and in those who had a major lung abnormality detected, but these differences were modest and temporary. Rollout of screening as a service or design of a full trial would need to address issues of outreach. The health-economic analysis suggests that the intervention could be cost-effective but this needs to be confirmed using data on actual lung cancer mortality.ConclusionsThe UK Lung Cancer Screening (UKLS) pilot was successfully undertaken with 4055 randomised individuals. The data from the UKLS provide evidence that adds to existing data to suggest that lung cancer screening in the UK could potentially be implemented in the 60–75 years age group, selected via the Liverpool Lung Project risk model version 2 and using CT volumetry-based management protocols.Future workThe UKLS data will be pooled with the NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek: Dutch–Belgian Randomised Lung Cancer Screening Trial) and other European Union trials in 2017 which will provide European mortality and cost-effectiveness data. For now, there is a clear need for mortality results from other trials and further research to identify optimal methods of implementation and delivery. Strategies for increasing uptake and providing support for underserved groups will be key to implementation.Trial registrationCurrent Controlled Trials ISRCTN78513845.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 40. See the NIHR Journals Library website for further project information.

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“…Most patients are diagnosed with advanced-stage tumors, precluding curative-intent treatment. Lung-cancer screening is aimed at decreasing lung-cancer-associated mortality and improving prognosis by detection at an early stage, especially stage I, which has the highest long-term survival rates (up to 90%) following surgical resection [1–3]. While lung-cancer screening trials using chest radiography have reported inconsistent findings [4–6], several studies using low-dose computed tomography (LDCT) scans have led to a re-evaluation of screening programs.…”

Section: Introductionmentioning

confidence: 99%

From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the french intergroup (IFCT) and the groupe d'Oncologie de langue française (GOLF)

et al. 2013

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BackgroundDespite advances in cancer therapy, mortality is still high except in early-stage tumors, and screening remains a challenge. The randomized National Lung Screening Trial (NLST), comparing annual low-dose computed tomography (LDCT) and chest X-rays, revealed a 20% decrease in lung-cancer-specific mortality. These results raised numerous questions. The French intergroup for thoracic oncology and the French-speaking oncology group convened an expert group to provide a coherent outlook on screening modalities in France.MethodsA literature review was carried out and transmitted to the expert group, which was divided into three workshops to tackle specific questions, with responses presented in a plenary session. A writing committee drafted this article.ResultsThe multidisciplinary group favored individual screening in France, when carried out as outlined in this article and after informing subjects of the benefits and risks. The target population involves subjects aged 55–74 years, who are smokers or have a 30 pack-year smoking history. Subjects should be informed about the benefits of quitting. Screening should involve LDCT scanning with specific modalities. Criteria for CT positivity and management algorithms for positive examinations are given.ConclusionsIndividual screening requires rigorous assessment and precise research in order to potentially develop a lung-cancer screening policy.

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Long-term prognosis of patients with lung cancer detected on low-dose chest computed tomography screening

Cited by 26 publications

References 22 publications

A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan

A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan

The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer

From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the french intergroup (IFCT) and the groupe d'Oncologie de langue française (GOLF)

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