Survival of patients with stage I lung cancer detected on CT screening.
BACKGROUND
The outcome among patients with clinical stage I cancer that is detected on annual screening using spiral computed tomography (CT) is unknown.


METHODS
In a large collaborative study, we screened 31,567 asymptomatic persons at risk for lung cancer using low-dose CT from 1993 through 2005, and from 1994 through 2005, 27,456 repeated screenings were performed 7 to 18 months after the previous screening. We estimated the 10-year lung-cancer-specific survival rate among participants with clinical stage I lung cancer that was detected on CT screening and diagnosed by biopsy, regardless of the type of treatment received, and among those who underwent surgical resection of clinical stage I cancer within 1 month. A pathology panel reviewed the surgical specimens obtained from participants who underwent resection.


RESULTS
Screening resulted in a diagnosis of lung cancer in 484 participants. Of these participants, 412 (85%) had clinical stage I lung cancer, and the estimated 10-year survival rate was 88% in this subgroup (95% confidence interval [CI], 84 to 91). Among the 302 participants with clinical stage I cancer who underwent surgical resection within 1 month after diagnosis, the survival rate was 92% (95% CI, 88 to 95). The 8 participants with clinical stage I cancer who did not receive treatment died within 5 years after diagnosis.


CONCLUSIONS
Annual spiral CT screening can detect lung cancer that is curable.
New York Presbyterian Hospital-Weill Medical College of Cornell University, New York 10021, USA. chensch@med.cornell.edu
Henschke
Claudia I
CI
Yankelevitz
David F
DF
Libby
Daniel M
DM
Pasmantier
Mark W
MW
Smith
James P
JP
Miettinen
Olli S
OS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001706:Biopsy; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016273:Occupational Exposure / Q000009:adverse effects; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
D014028:Tobacco Smoke Pollution