Computed tomography screening for lung cancer: applicability of an international protocol in a single-institution environment.
BACKGROUND
The purpose of this study was to assess the applicability of an annual low-dose computed tomography (CT) screening program for lung cancer in a single institution in Israel, which has a relatively lower prevalence of lung cancer compared with other Western countries, and to examine stage distribution of detected lung cancers.


METHODS
A cohort of 842 former and current smokers underwent baseline low-dose CT screening and a total of 942 annual repeat screenings over a period of 68 months. The definition of positive results on baseline and repeat screening and their diagnostic workup were guided by the common International Early Lung Cancer Action Program protocol. Recommendations for biopsy of suspicious nodules were based on nodule size, nodule growth, non-resolution following antibiotic therapy, and positron emission tomography scan.


RESULTS
The test result was positive in 102 of the 842 baseline screenings (12%) and in 45 of the 942 annual repeat screenings (5%), and biopsy was recommended in 12 baseline and 2 annual screenings. Twelve of the 14 cancers diagnosed (86%) were stage I tumors.


CONCLUSIONS
Our study indicates that the adoption of a common international protocol is feasible, even in a very different clinical setting, yielding a high proportion of early-stage lung cancers.
Shaham
Dorith
D
Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel. dshaham@hadassah.org.il
Breuer
Raphael
R
Copel
Laurian
L
Agid
Ronit
R
Makori
Arnon
A
Kisselgoff
David
D
Goitein
Orly
O
Izhar
Uzi
U
Berkman
Neville
N
Heching
Norman
N
Sosna
Jacob
J
Bar-Ziv
Jacob
J
Libson
Eugene
E
D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed