title: Screening for lung cancer with low-dose spiral computed tomography.
abstract: Studies suggest that screening with spiral computed tomography can detect lung cancers at a smaller size and earlier stage than chest radiography can. To evaluate low-radiation-dose spiral computed tomography and sputum cytology in screening for lung cancer, we enrolled 1,520 individuals aged 50 yr or older who had smoked 20 pack-years or more in a prospective cohort study. One year after baseline scanning, 2,244 uncalcified lung nodules were identified in 1,000 participants (66%). Twenty-five cases of lung cancer were diagnosed (22 prevalence, 3 incidence). Computed tomography alone detected 23 cases; sputum cytology alone detected 2 cases. Cell types were: squamous cell, 6; adenocarcinoma or bronchioalveolar, 15; large cell, 1; small cell, 3. Twenty-two patients underwent curative surgical resection. Seven benign nodules were resected. The mean size of the non-small cell cancers detected by computed tomography was 17 mm (median, 13 mm). The postsurgical stage was IA, 13; IB, 1; IIA, 5; IIB, 1; IIIA, 2; limited, 3. Twelve (57%) of the 21 non-small cell cancers detected by computed tomography were stage IA at diagnosis. Computed tomography can detect early-stage lung cancers. The rate of benign nodule detection is high.
authors.affiliation: Department of Radiology, the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. schwartz.roberta@mayo.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Swensen
authors.forename: James R
authors.initials: JR
authors.lastname: Jett
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: David E
authors.initials: DE
authors.lastname: Midthun
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Hartman
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Sykes
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Aughenbaugh
authors.forename: Frank E
authors.initials: FE
authors.lastname: Zink
authors.forename: Shauna L
authors.initials: SL
authors.lastname: Hillman
authors.forename: Gayle R
authors.initials: GR
authors.lastname: Noetzel
authors.forename: Randolph S
authors.initials: RS
authors.lastname: Marks
authors.forename: Amy C
authors.initials: AC
authors.lastname: Clayton
authors.forename: Peter C
authors.initials: PC
authors.lastname: Pairolero
mesh_terms: D000368:Aged; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking; D013183:Sputum / Q000166:cytology; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology