Lung cancer screening update.
Low-dose computed tomography (ld-CT) for lung cancer screening in high-risk subjects is performed within clinical trials and has started to be used in routine clinical practice. The technique is well defined, even if some methodological problems are still debated, such as the measurements of pulmonary nodules, the size to define them as clinically significant, the management of small or non-solid nodules and the best diagnostic work-up to optimize diagnostic accuracy. The data derived from an IEO observational study, started in 2000, shows a high prevalence and incidence of early stage lung cancer detected at ld-CT, demonstrating the need to prolong observation for a long period of time. The high survival rate of patients with screening-detected cancer has recently been debated in a number of papers using statistical models, but the advantage of the yearly ld-CT for the individuals is unquestionable; its benefit on the population base has still to be demonstrated by ongoing randomized trials.
Bellomi
Massimo
M
Diagnostic Radiology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. massimo.bellomi@ieo.it
Rampinelli
Cristiano
C
De Fiori
Elvio
E
Preda
Lorenzo
L
Veronesi
Giulia
G
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012306:Risk; D012680:Sensitivity and Specificity; D012907:Smoking / Q000009:adverse effects; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data