title: Lung and pleural CT signs predict deaths: 10-year follow-up after lung cancer screening of asbestos-exposed workers.
abstract: OBJECTIVE
  To work out the predictive value of pathological (HR)CT signs concerning long-term mortality among those screened for lung cancer.
  
  
  METHODS
  Five hundred and eighty four construction workers (574 males, 10 females) were originally screened for lung cancer and found negative. Their images were also scored for several lung and pleural signs. Mortality data were checked from the National Registry of Causes of Death. Cox regression adjusted for age, sex, smoking, BMI, and asbestos exposure was used to explore the relations between the radiological signs and deaths. The mean follow-up time was 10.53 years (0.56-12.98 years) and a total of 6,150 person years were followed up.
  
  
  RESULTS
  Altogether, 185 deaths occurred (64 cardiovascular, 51 cancer, 24 non-cancer respiratory deaths, and 46 deaths from other causes). All studied emphysema signs were significant predictors of all-cause deaths as were most fibrosis signs (subpleural nodules, septal lines, parenchymal bands, and honeycombing), ground-glass opacities, thickened bronchial walls, pleural plaque extent, and adherences. Cardiovascular deaths were significantly associated with paraseptal emphysema and bullae. Several lung/pleural signs also predicted cancer and respiratory deaths.
  
  
  CONCLUSIONS
  Pathological lung/pleural CT signs found in screening seem to predict deaths in long term, which may require more careful medical surveillance of such individuals. Further studies are needed to generalize the present findings to general population.
authors.affiliation: Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250, Helsinki, Finland. tapio.vehmas@ttl.fi
authors.forename: Tapio
authors.initials: T
authors.lastname: Vehmas
authors.forename: Panu
authors.initials: P
authors.lastname: Oksa
authors.forename: Leena
authors.initials: L
authors.lastname: Kivisaari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D060389:Construction Industry; D055088:Early Detection of Cancer; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D010994:Pleura / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging; D012140:Respiratory Tract Diseases / Q000401:mortality*; D012907:Smoking; D036542:Tomography, Spiral Computed
chemical_list: D001194:Asbestos