Low-Dose Computer Tomography as a Screening Tool for Lung Cancer in a High Risk Population

Abstract

The aim of the study was to evaluate the usefulness of low-dose computer tomography as a screening tool for early stage lung cancer. The study was performed in 332 individuals aged 55-70 who were asymptomatic, who had not previously suffered from cancer, and who smoked at least ten packs of cigarettes a year. Baseline and repeated LD-CT scans were performed. Pulmonary nodules were classified according to the size and morphology, and the results were categorized as negative (no nodules observed), semi-positive (nodules of 4 mm or smaller in diameter) and positive (nodules 5 mm or larger). Based on the category of the patient, either a repeat low-dose CT, a bronchoscopy with or without a biopsy, or a PET-CT was performed. The baseline screening showed 59 positive results. Eighteen patients were hospitalized and underwent bronchoscopy and biopsy. One of these patients had Stage I non small cell lung carcinoma (NSCLC) and a lobectomy was performed. Three patients had Stage IV NSCLC and were referred for chemotherapy. We identified 103 semi-positive results. Only 25 of those patients had a repeat scan because of noncompliance. We observed no significant growth of diagnosed nodules in a semi-positive group. Low-dose CT can be used as a screening tool for early stage lung cancer. A high percentage of false-positive results are observed. There are difficulties in diagnosing nodules in patients with post-tuberculosis changes. A high rate of noncompliance was noticed.

Lung cancers and pulmonary nodules detected by computed tomography scan: a population-level analysis of screening cohorts

“…Finally, a total of 37 studies involving 163,442 participants were included in our study, containing 10 RCTs and 27 cohort studies. One study started screening at 35 years of age (31), seven studies started screening at 40 years of age (4,24,25,(32)(33)(34)(35), three studies at 45 years of age (26,27,36), sixteen studies at 50 years of age (18)(19)(20)(21)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48), and ten studies at 55 years of age (17,22,23,(49)(50)(51)(52)(53)(54)(55). The starting age for lung cancer screening varied from country to country.…”

A narrative review of lung cancer screening implementation: increasing utilization of evidence-based practice

“…Usman Ali and colleagues ( 9) summarized the consequences of false positives in multiple studies. Among 40,569 patients screened with LDCT in 8 studies (28,38,41,(46)(47)(48)(49)(50), 403 with benign conditions underwent minor invasive procedures as part of diagnostic followup; resulting in an absolute number of 9.74 patients with benign conditions undergoing minor invasive procedures (95% CI: 4.34-15.15) per 1,000 screened. Among 66,535 patients in 17 studies (18,19,26,28,38,41,46,47,(50)(51)(52)(53)(54)(55)(56)(57)(58) that reported data on major invasive procedures, 411 underwent major invasive procedures as part of the diagnostic evaluation of false positive findings, resulting in an absolute number of 5.28 patients with benign conditions undergoing major invasive procedures (95% CI: 3.94-6.62) per 1,000 screened.…”

Is it possible for pyruvate kinase to be a non-small cell lung cancer marker?

“…Aktualnie stosowaną, skuteczną metodą skriningową w raku płuca jest niskodawkowa tomografia komputerowa. Jej stosowanie jest jednak ograniczone przez wysokie koszty [32]. Jednocześnie rozpoczęcie ukierunkowanej diagnostyki następuje na ogół w okresie od 4,5 do 8 miesię-cy od momentu pojawienia się pierwszych objawów raka płuca [10], co istotnie zmniejsza szanse na zastosowanie radykalnego zabiegu operacyjnego.…”