Outcome of patients with lung cancer detected via mass screening as compared to those presenting with symptoms

Shimizu, Nobuyoshi; Ando, Akio; Teramoto, Shigeru; Moritani, Yoshiaki; Nishii, Kenji

doi:10.1002/jso.2930500103

Cited by 19 publications

(10 citation statements)

References 6 publications

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“…First, 34 (20%) of 171 consecutive patients with lung cancer were excluded from the study. The survival of patients with lung cancer detected by the presence of symptoms has been reported to be worse than those of patients with lung cancer detected on screening 17–19 . As all of 18 symptomatic patients had lung cancers detected by CXR and might decrease the survival rate in the control group, they were excluded.…”

Section: Discussioncontrasting

confidence: 53%

Outcome in patients with lung cancer invisible on chest roentgenograms but detected only by helical computed tomography

Kashiwabara¹,

Kohshi²

2006

Respirology

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The aim of this study was to evaluate the prognosis for patients with lung cancer detected by helical CT but not by CXR. One hundred and thirty-seven asymptomatic patients with lung cancer diagnosed by annual mass screening of the chest were enrolled over a 7-year period. Five-year survival rates in patients with lung cancer detected only by helical CT (n = 19: CT-only detection group) and in patients with lung cancer visible by both CXR and helical CT (n = 118: control group) were evaluated, and clinical variables were examined as possible predictors of survival time using the Cox proportional-hazards model. There was a significant difference between the 5-year survival rates in the CT-only detection group and in the control group (80% vs. 39%, log rank: P = 0.0171). The risk of death decreased 77% in CT-only detectable lung cancer (hazard ratio: 0.219, 95% confidence interval: 0.057-0.845, P = 0.0275). Lung cancer could not be seen by CXR because nodules were small or faint (n = 11) or overlapping a shadow of thoracic components (n = 8). The percentage of subsolid nodules (classified as either part-solid or non-solid nodules) was higher in the subgroup with small or faint nodules (82% vs. 25%, P = 0.0423). Helical CT has the ability to detect early lung cancer before the small or faint nodules increase to a size visible on CXR, and patients with lung cancer detected only by helical CT have a better prognosis.

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Section: Discussioncontrasting

confidence: 53%

Outcome in patients with lung cancer invisible on chest roentgenograms but detected only by helical computed tomography

Kashiwabara¹,

Kohshi²

2006

Respirology

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“…Early detection presently relies on chest radiography examinations performed on asymptomatic patients for other diagnostic purposes. There have been studies that favor using chest radiography as a screening tool (Shimizu 1992, Brett 1969). However, the usefulness of such a screening program for lung cancer has been questioned based upon its ineffectiveness either in diagnosis (Gurney 1995) or in changing the mortality rate once the cancer is diagnosed (Fontana 1991).…”

Section: Discussionmentioning

confidence: 99%

Bi-plane correlation imaging for improved detection of lung nodules

et al. 2003

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Bi-plane correlation imaging (BCI) is a new imaging approach that utilizes angular information from a bi-plane digital acquisition in conjunction with computer assisted detection (CAD) to reduce the degrading influence of anatomical noise in the detection of subtle lesions in planar images. An anthropomorphic chest phantom, supplemented with added nodule phantoms (5-13 mm at the image plane), was imaged from different posterior projections within a ±12 o range by moving the x-ray tube vertically and horizontally with respect to the detector. Each image was analyzed using a basic front-end single-view CAD algorithm. The correlation of the suspect lesions from the PA view with those from each of the oblique views was examined using a priori knowledge of the acquisition geometry. The correlated suspect lesions were registered as positive. Using an optimum -3 o vertical geometry and processing parameters, BCI resulted in 62.5% sensitivity, 1.5 FP/image, and 0.885 PPV. The corresponding values from the observer experiment were 56% sensitivity, 10.8 FP/image, and 0.45 PPV, respectively. Compared to single-view CAD results, the BCI reduced sensitivity by 20%. However, the corresponding reduction in FPs was notably higher (94%) leading to 140% improvement in the PPV. Changes in processing parameters could result in higher PPV and lower FP/image at the expense of lower sensitivity. Similar findings were indicated for small (5-9 mm) and large (9-13 mm) nodules, but the relative improvement was significantly higher for smaller nodules. (The research was supported by a grant from the NIH, R21CA91806.)

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“…Data have been consistent and in accordance with the Mayo screening study, showing that stage shift could be obtained. More cases of stage I-II squamous cancer amenable for surgical resection have been detected, leading to a higher resection and survival rate [34][35][36][37]. Individuals with early stage SCC in their central airways seemed to benefit most because they had sputum-positive but radiographically occult lung cancer (ROLC).…”

Section: The Target Populationmentioning

confidence: 99%

“…Treatments offered have been both surgical and bronchoscopic, e.g. photodynamic therapy [30,[32][33][34][35][36][37][38].…”

Section: Sputum Cytology Screeningmentioning

confidence: 99%

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New techniques for early detection of lung cancer

Sutedja¹

2003

Eur Respir J

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The resurgence of interest in lung cancer screening and the application of new techniques for the management of early cancer have raised various issues regarding this global epidemic. In previous randomised clinical trials, the use of conventional chest radiographs and sputum cytology examinations for screening have been shown not to reduce lung cancer mortality.The use of biomolecular markers, autofluorescence bronchoscopy, low-dose spiral and high-resolution computed tomography, endobronchial ultrasonography, optical coherence tomography, confocal micro-endoscopy, positron emission tomography in combination with video-assisted thoracic surgery and intraluminal bronchoscopic treatments may provide new modalities with which to manage lung cancer at the earliest stage possible.New hopes arise that the combined use of more accurate and minimally invasive diagnostic and treatment techniques may justify screening and reduce mortality. More individuals may also benefit, as many in the target population already suffer from poor cardiovascular and pulmonary health due to their smoking history and are considered at risk for surgical intervention. The cost-effectiveness of lung cancer screening will strongly depend on the proper selection of the target population and the optimal application of these new techniques.Despite epidemiological controversy regarding lung cancer screening, the feasibility to define more precisely who are at risk and the use of less invasive techniques may preserve quality of life and improve the survival of many lung cancer patients.

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Outcome of patients with lung cancer detected via mass screening as compared to those presenting with symptoms

Cited by 19 publications

References 6 publications

Outcome in patients with lung cancer invisible on chest roentgenograms but detected only by helical computed tomography

Outcome in patients with lung cancer invisible on chest roentgenograms but detected only by helical computed tomography

Bi-plane correlation imaging for improved detection of lung nodules

New techniques for early detection of lung cancer

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