title: Feasibility of a screening programme for lung cancer in former asbestos workers.
abstract: BACKGROUND
  Low-dose computed tomography (CT) has been found to detect more Stage IA lung cancer than chest x-ray.
  
  
  OBJECTIVE
  To investigate whether lung cancer screening with CT was effective and acceptable in former asbestos workers.
  
  
  METHODS
  CT scanning was carried out following the protocol previously described in the literature. A questionnaire was used to assess cumulative asbestos exposure. An economic analysis was also performed. Informed consent was obtained from all patients.
  
  
  RESULTS
  A total of 1119 male asbestos workers (58% of invited) were examined, of whom 65% were smokers or ex-smokers. Mean age was 57.1 years with mean cumulative exposure to asbestos of 123 fibres/ml x years. Pleural plaques were found in 375 workers (32%), while 338 workers (29%) were included in the radiological follow-up, which led to 25 biopsies (13 of lung, 9 of pleura, 3 of both) and five screen-detected lung cancers (0.4%), one in Stage I. Incidence rate was 149 per 10(5), equal to that in the male general population of similar age. The expenses for diagnosis were 1014 and 244962 Euro per screened subject and screen-detected lung cancer case, respectively.
  
  
  CONCLUSIONS
  Screening adherence and frequency of detection were low, while costs and radiation dose were high. In spite of a high cumulative asbestos exposure, lung cancer risk was not increased relative to the general population. The screening programme was not felt to be cost-effective from the perspective of the government as a third-party funding agency.
authors.affiliation: Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy. giuseppe.mastrangelo@unipd.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mastrangelo
authors.forename: Maria Nicoletta
authors.initials: MN
authors.lastname: Ballarin
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bellini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Bizzotto
authors.forename: Federica
authors.initials: F
authors.lastname: Zannol
authors.forename: Francesco
authors.initials: F
authors.lastname: Gioffrè
authors.forename: Mario
authors.initials: M
authors.lastname: Gobbi
authors.forename: Gianna
authors.initials: G
authors.lastname: Tessadri
authors.forename: Luciano
authors.initials: L
authors.lastname: Marchiori
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marangi
authors.forename: Saverio
authors.initials: S
authors.lastname: Bozzolan
authors.forename: John H
authors.initials: JH
authors.lastname: Lange
authors.forename: Flavio
authors.initials: F
authors.lastname: Valentini
authors.forename: Paolo
authors.initials: P
authors.lastname: Spolaore
mesh_terms: D000328:Adult; D001194:Asbestos; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005240:Feasibility Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D008654:Mesothelioma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009784:Occupational Diseases / Q000000981:diagnostic imaging*; D016273:Occupational Exposure; D010995:Pleural Diseases / Q000175:diagnosis; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000191:economics
chemical_list: D001194:Asbestos