Screening for Lung Cancer With Low-Dose Helical Computed Tomography: Anti-Lung Cancer Association Project

作者：Tomotaka Sobue, Noriyuki Moriyama, Masahiro Kaneko, Masahiko Kusumoto, Toshiaki Kobayashi, Ryosuke Tsuchiya, Ryutaro Kakinuma, Hironobu Ohmatsu, Kanji Nagai, Hiroyuki Nishiyama, Eisuke Matsui, Kenji Eguchi · 发表于：Journal of Clinical Oncology · 年份：2002 · DOI：10.1200/jco.2002.20.4.911 · 被引用次数：423 · 研究领域：Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging、Advanced Radiotherapy Techniques

PURPOSE: Because efficacy of lung cancer screening using chest x-ray is controversial and insufficient, other screening modalities need to be developed. To provide data on screening performance of low-dose helical computed tomography (CT) scanning and its efficacy in terms of survival, a one-arm longitudinal screening project was conducted. PATIENTS AND METHODS: A total of 1,611 asymptomatic patients aged 40 to 79 years, 86% with smoking history, were screened by low-dose helical CT scan, chest x-ray, and 3-day pooled sputum cytology with a 6-month interval. RESULTS: At initial screening, the proportions of positive tests were 11.5%, 3.4%, and 0.8% with low-dose helical CT scan, chest x-ray, and sputum cytology, respectively. In 1,611 participants, 14 (0.87%) cases of lung cancer were detected, with 71% being stage IA disease and a mean tumor diameter of 19.8 mm. At repeated screening, the proportions of positive tests were 9.1%, 2.6%, and 0.7% with low-dose helical CT, chest x-ray, and sputum cytology, respectively. In 7,891 examinations, 22 (0.28%) cases of lung cancer were detected, with 82% being stage IA disease and a mean tumor diameter of 14.6 mm. The 5-year survival rate for screen-detected lung cancer was 76.2% and 64.9% for initial and repeated screening, respectively. CONCLUSION: Screening with low-dose helical CT has potential to improve screening efficacy in terms of reducing lung cancer mortality. An evaluation of efficacy using appropriate methods is urgently r...