title: Early lung cancer action project: a summary of the findings on baseline screening.
abstract: OBJECTIVE
  The Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low radiation dose computed tomography (low-dose CT) in persons at high-risk for lung cancer.
  
  
  METHODS
  Since starting in 1993, the ELCAP has enrolled 1,000 asymptomatic persons, 60 years of age or older, with at least 10 pack-years (1 pack per day for 10 years, or 2 packs per day for 5 years) of cigarette smoking, no prior cancer, and medically fit to undergo thoracic surgery. After a structured interview and informed consent, baseline chest radiographs and low-dose CT were obtained on each subject. The diagnostic work-up of screen-detected noncalcified pulmonary nodules (NCN) was guided by ELCAP recommendations which included short-term high-resolution CT follow-up for the smallest nodules. Baseline
  
  
  RESULTS
  On low-dose CT at baseline compared to chest radiography, NCN were detected three times as commonly (23% versus 7%), malignancies four times as commonly (2.7% versus 0.7%), and stage I malignancies six times as commonly (2.3% versus 0.4%). Of the 27 CT-detected cancers, 96% (26/27) were resectable; 85% (23/27) were stage I, and 83% (19 of the 23 stage I) were not seen on chest radiography. Following the ELCAP recommendations, biopsies were performed on 28 of the 233 subjects with NCN; 27 had a malignant and one a benign NCN. Another three individuals underwent biopsy outside of the ELCAP recommendations; all had benign NCNS: No one had thoracotomy for a benign nodule.
  
  
  CONCLUSIONS
  Baseline CT screening for lung cancer provides for detecting the disease at earlier and presumably more commonly curable stages in a cost-effective manner.
authors: Department of Radiology, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA.
authors: C I
authors: CI
authors: Henschke
authors: D I
authors: DI
authors: McCauley
authors: D F
authors: DF
authors: Yankelevitz
authors: D P
authors: DP
authors: Naidich
authors: G
authors: G
authors: McGuinness
authors: O S
authors: OS
authors: Miettinen
authors: D
authors: D
authors: Libby
authors: M
authors: M
authors: Pasmantier
authors: J
authors: J
authors: Koizumi
authors: N
authors: N
authors: Altorki
authors: J P
authors: JP
authors: Smith
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008403:Mass Screening; D009367:Neoplasm Staging; D015995:Prevalence; D013902:Radiography, Thoracic; D012107:Research Design; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed