Currently available results on CT screening for lung cancer show that (1) the work-up on baseline screening can be confined to less than 15% of the individuals and to less than 6% on annual repeat screening, (2) almost all cases are detected by screening with very few diagnoses made between screening on the prompting of symptoms, and (3) over 80% of all the diagnoses are of stage I. This diagnostic performance results from following the I-ELCAP regimen of screening which defines a positive result of the initial CT in the regimen as well as the work-up leading to a diagnosis of lung cancer. The diagnostic performance raises prognostic questions as to the genuineness and curability of these screen-diagnosed lung cancers. All diagnoses of malignancy were confirmed by an expert pathology review and found to represent genuine lung cancer as defined by the 2004 World Health Organization pathologic criteria. Estimates based on growth rates suggest that about 90% of the baseline-diagnosed stage I cancers are genuine cancers, as are essentially all of those diagnosed on annual repeat screening. Preliminary results of the curability of genuine screen-diagnosed stage I lung cancers indicate a high curability rate of more than 90%. This suggests that more than a high proportion of deaths from lung cancer can be prevented by CT screening followed by early resection. Using these results, the benefit of a single round of CT screening can be determined for an individual based on the age and smoking history.
Bibliographical noteFunding Information:
Joan & Sanford I. Weill Medical College of Cornell University, New York, NY: Claudia I. Henschke, Principal Investigator, David F. Yankelevitz, Dorothy I. McCauley Azumi Hospital, Nagano, Japan: Shusuke Sone, Takaomi Hanaoka CBNS, City University of New York at Queens College, Queens, NY: Steven Markowitz, Albert Miller LungenZentrum Hirslanden, Zurich, Switzerland: Karl Klingler, Thomas Scherer, Rolf Inderbitzi H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL: Melvyn Tockman Hadassah Medical Organization, Jerusalem, Israel: Dorith Shaham Clinica Universitaria de Navarra, Pamplona, Spain: Javier Zulueta, Gorka Bastarrika, Maria D. Lozano Swedish Medical Center, Seattle, WA: Kim Rice, Ralph Aye National Cancer Institute Regina Elena, Rome, Italy: Salvatore Giunta, Marcello Crecco, Patrizia Pugliese State University of New York at Stony Brook, Stony Brook, NY: Matthew Rifkin, Eddie S. Fiori Columbia University Medical Center, New York, NY: John H.M. Austin, Gregory D.N. Pearson Maimonides Medical Center, Brooklyn, NY: Samuel Kopel Roswell Park Cancer Institute, Buffalo, NY: Donald Klippenstein, Alan Litwin, Peter A. Loud Christiana Care, Helen F. Graham Cancer Center, Newark, DE: Thomas Bauer, James Lally State University of New York, Upstate Medical Center, Syracuse, NY: Leslie J. Kohman, Ernest M. Scalzetti North Shore-Long Island Jewish Health System, New Hyde Park, NY: Arfa Khan, Rakesh Shah New York University Medical Center, New York, NY: David Naidich, Georgeann McGuinness Georgia Institute for Lung Cancer Research, Atlanta, GA: Michael V. Smith, Hadyn T. Williams, Louis Lovett University of Toronto, Princess Margaret Hospital, Toronto, Canada: Heidi Roberts, Demetris Patsios Mount Sinai School of Medicine, New York, NY: David S. Mendelson Memorial Sloan-Kettering Cancer Center, New York, NY: Robert T. Heelan, Michelle S. Ginsberg Jackson Memorial Hospital, University of Miami, Miami, FL: Robert Thurer Mount Sinai Comprehensive Cancer Center, Miami Beach, FL: Shari-Lynn Odzer New York Medical College, Valhalla, NY: Terence A.S. Matalon Eisenhower Lucy Curci Cancer Center, Rancho Mirage, CA: Davood Vafai Our Lady of Mercy Medical Center, Bronx, NY: Peter H. Wiernik The 5 th Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China: Xueguo Liu Karmanos Cancer Institute, Detroit, MI: Harvey Pass, Carmen Indress Dorothy E. Schneider Cancer Center, Mills-Peninsula Health Services, San Mateo, CA: Barry Sheppard Evanston Northwestern Healthcare Medical Group, Evanston, IL: Daniel Ray Greenwich Hospital, Greenwich, CT: David Mullen Sharp Memorial Hospital, San Diego, CA: Michael Kalafer City of Hope National Medical Center, Duarte, CA: Fred Grannis, Arnie Rotter Holy Cross Hospital Cancer Institute, Silver Spring, MD: Frank Sullivan, Marlana Ottinger Comprehensive Cancer Center, Desert Regional Medical Center, Palm Springs, CA: Elber Camacho St.Agnes Cancer Center, Baltimore, MD: Enser Cole ProHealth Care Regional Cancer Center, Waukesha and Oconomowoc Memorial Hospitals, Oconomowoc, WI: M. Kristin Thorsen, Richard Hansen
- Cause of Death
- Lung Neoplasms/diagnostic imaging
- Mass Screening/methods
- Neoplasm Staging
- Tomography, X-Ray Computed