Lung cancer screening--comparison of computed tomography and X-ray.
Recent studies on lung cancer screening with CT disclosed a discrepancy between its efficiency in detecting early lung cancer and a lack of proof for decreasing mortality from lung cancer. The present study, in a city in Japan where an X-ray screening program is provided, bi-annual CT screening was performed for X-ray screening negative subjects for 4 years. Ten patients with lung cancer were detected among 22,720 person-year subjects (0.044%) through the X-ray screening. Among the X-ray screening-negative subjects, 3305 subjects participated in a CT screening program resulting in the detection of 15 patients with lung cancer (0.454%). All 15 cases detected by CT screening and 5 of the 10 cases detected by X-ray screening were at stage IA. In respect of gender, histological type and CT findings, patients detected by CT screening had a better prognostic profile than those detected by X-ray screening. Survival was significantly better in the former than the latter, both in its entirety comparison and in a comparison limited to patients who underwent surgery. In conclusion, CT screening might have the potential to detect lung cancer with good prognostic factors not limited to early detection. Sufficiently long follow-up time, therefore, would be required to evaluate the efficacy for decreasing lung cancer mortality with CT screening.
Fujikawa
Ayako
A
Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan. wadabun@fa2.so-net.ne.jp
Takiguchi
Yuichi
Y
Mizuno
Satoko
S
Uruma
Takahiro
T
Suzuki
Kiminori
K
Nagao
Keiichi
K
Niijima
Mafumi
M
Edo
Hidenori
H
Hino
Mitsunori
M
Kuriyama
Takayuki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D014055:Tomography, Emission-Computed / Q000379:methods / Q000592:standards; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards