Screening for second primary lung cancer after treatment of laryngeal cancer.
OBJECTIVE
As a result of smoking, patients who have received curative treatment for laryngeal cancer run a high risk of developing lung cancer. Therefore, these patients enter a screening program that aims to detect lung cancer at an asymptomatic stage. The study evaluated whether screening for lung cancer by means of regular chest x-ray examinations contributed to prolonging survival.


METHODS
A longitudinal follow-up study was performed to analyze the survival of patients who had received curative treatment for squamous cell laryngeal cancer and developed lung cancer during the follow-up period.


METHODS
Patients with lung cancer were divided into two groups: 1) patients with asymptomatic screen-detected lung cancer and 2) patients with complaints indicating lung cancer, whose tumor was detected in the interval between screening examinations by chest x-ray films.


RESULTS
In the complete group of patients with laryngeal cancer, no prognostic factors could be identified for developing lung cancer. There was no prolongation of survival in the screen-detected asymptomatic lung cancer patients. The median survival of both groups was 56 months (P =.57). The date of detection of the lung cancer was clearly brought forward by screening; a difference of 8 months was found between the median detection date of the two groups (P <.001). There was no difference in tumor-specific mortality between the two groups.


CONCLUSIONS
Screening by chest x-ray examination to detect lung cancer in an asymptomatic stage after curative treatment for squamous cell laryngeal cancer does not improve survival for patients who develop lung cancer.
Ritoe
Savitri C
SC
Department of Otorhinolaryngolgy-Head and Neck Surgery, University Medical Center Nijmegen, The Netherlands.
Krabbe
Paul F M
PF
Jansen
Margriet M G
MM
Festen
Jan
J
Joosten
Frank B M
FB
Kaanders
J Hans A M
JH
van den Hoogen
Frank J A
FJ
Verbeek
André L M
AL
Marres
Henri A M
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000628:therapy; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging*; D011859:Radiography; D018709:Statistics, Nonparametric; D015996:Survival Rate