Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling

作者：Mathilde Marie Winkler Wille, Asger Dirksen, Haseem Ashraf, Zaigham Saghir, Karen Bach, John Brodersen, Paul Frost Clementsen, Hanne Helene Hansen, Klaus Richter Larsen, Jann Mortensen, Jakob Fraes Rasmussen, Niels Jørgen Seersholm, Birgit Guldhammer Skov, Laura H. Thomsen, Philip Tønnesen, Jesper Holst Pedersen · 发表于：American Journal of Respiratory and Critical Care Medicine · 年份：2015 · DOI：10.1164/rccm.201505-1040oc · 被引用次数：345 · 研究领域：Lung Cancer Diagnosis and Treatment、Lung Cancer Treatments and Mutations、Global Cancer Incidence and Screening

RATIONALE: As of April 2015, participants in the Danish Lung Cancer Screening Trial had been followed for at least 5 years since their last screening. OBJECTIVES: Mortality, causes of death, and lung cancer findings are reported to explore the effect of computed tomography (CT) screening. METHODS: A total of 4,104 participants aged 50-70 years at the time of inclusion and with a minimum 20 pack-years of smoking were randomized to have five annual low-dose CT scans (study group) or no screening (control group). MEASUREMENTS AND MAIN RESULTS: Follow-up information regarding date and cause of death, lung cancer diagnosis, cancer stage, and histology was obtained from national registries. No differences between the two groups in lung cancer mortality (hazard ratio, 1.03; 95% confidence interval, 0.66-1.6; P = 0.888) or all-cause mortality (hazard ratio, 1.02; 95% confidence interval, 0.82-1.27; P = 0.867) were observed. More cancers were found in the screening group than in the no-screening group (100 vs. 53, respectively; P < 0.001), particularly adenocarcinomas (58 vs. 18, respectively; P < 0.001). More early-stage cancers (stages I and II, 54 vs. 10, respectively; P < 0.001) and stage IIIa cancers (15 vs. 3, respectively; P = 0.009) were found in the screening group than in the control group. Stage IV cancers were nonsignificantly more frequent in the control group than in the screening group (32 vs. 23, respectively; P = 0.278). For the highest-stage cancers (T4N3M1, 21 vs. 8...