Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer.
The Lung Screening Study (LSS) was a pilot study designed to assess the feasibility of conducting a large scale randomized controlled trial (RCT) of low radiation dose spiral computed tomography (LDCT) versus chest X-ray (CXR) for lung cancer screening. Baseline results of LSS have been previously reported. Here, we report on the findings at the year one screen and on the final results of the LSS study. A total of 1660 subjects were randomized to the LDCT arm and 1658 to the CXR arm. Compliance with screening declined from 96% at baseline to 86% at year one in the LDCT arm and declined from 93% at baseline to 80% at year one in the CXR arm. Positivity rates for the year one screen were 25.8% for LDCT and 8.7% for CXR. Cancer yield was significantly less at year one for LDCT, 0.57%, than at baseline, 1.9%; cancer yield for CXR increased from 0.45% at baseline to 0.68% at year one. Forty lung cancers in the LDCT arm and 20 in the CXR arm were diagnosed over the study period. Stage I cancers comprised 48% of cases in the LDCT arm and 40% in the CXR arm. A total of 16 stage III-IV cancers were observed in the LDCT arm versus nine in the CXR arm. The LSS has established the feasibility of a RCT comparing annual spiral CT to chest X-ray for lung cancer screening.
Gohagan
John K
JK
Division of Cancer Prevention, National Cancer Institute, 6130 Executive Blvd., EPN 3064, Bethesda, MD 20892, USA.
Marcus
Pamela M
PM
Fagerstrom
Richard M
RM
Pinsky
Paul F
PF
Kramer
Barnett S
BS
Prorok
Philip C
PC
Ascher
Susan
S
Bailey
William
W
Brewer
Brenda
B
Church
Timothy
T
Engelhard
Deborah
D
Ford
Melissa
M
Fouad
Mona
M
Freedman
Matthew
M
Gelmann
Edward
E
Gierada
David
D
Hocking
William
W
Inampudi
Subbarao
S
Irons
Brian
B
Johnson
Christine Cole
CC
Jones
Arthur
A
Kucera
Gena
G
Kvale
Paul
P
Lappe
Karen
K
Manor
William
W
Moore
Alisha
A
Nath
Hrudaya
H
Neff
Sarah
S
Oken
Martin
M
Plunkett
Michael
M
Price
Helen
H
Reding
Douglas
D
Riley
Thomas
T
Schwartz
Martin
M
Spizarny
David
D
Yoffie
Roberta
R
Zylak
Carl
C
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed