title: Long-term outcomes of a pilot CT screening for lung cancer.
abstract: BACKGROUND
  Low-dose computed tomography (CT) screening can detect early stage lung cancer in high-risk populations. However, no data on repeated annual screening over more than 5 years are available, and the impact of screening on lung cancer mortality is controversial.
  
  
  METHODS
  We analysed outcomes in high-risk asymptomatic volunteers (smokers and former smokers, >50 years) enrolled in a pilot study over 1 year from June 2000, who received annual low-dose CT for 7 years. Cumulative lung cancer incidence and survival were represented by Kaplan-Meier curves. Standardized incidence and mortality ratios were used to estimate risks relative to the general Italian and US population.
  
  
  RESULTS
  Compliance was 86% at the end of the seventh year in 1035 recruited volunteers (71% men, mean age 58 years). Lung cancer was diagnosed in 54 (5.3%); radical surgery was possible in 48/54 (87%); 39/54 (72%) had stage I disease. Five-year survival was 63% overall, 89% for stage I cases. During 6308 person-years of observation, 47 participants had died versus 75 expected in the Italian general population standardised for age and sex. Fourteen lung cancer deaths were registered versus 27 expected in a standardised US smoker population.
  
  
  CONCLUSIONS
  Seventy percent of screening-diagnosed patients had stage I disease, and the survival of screen-detected cancer patients was high. Lung cancer mortality was favourable compared to age- and sex-matched population of US smokers, suggesting that mortality can be lowered by screening, although larger trials with longer follow-up are necessary to confirm these findings.
authors.affiliation: Department of Thoracic Surgery.
authors.forename: G
authors.initials: G
authors.lastname: Veronesi
authors.forename: P
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: L
authors.initials: L
authors.lastname: Spaggiari
authors.forename: C
authors.initials: C
authors.lastname: Rampinelli
authors.forename: G
authors.initials: G
authors.lastname: Pelosi
authors.forename: L
authors.initials: L
authors.lastname: Preda
authors.forename: F
authors.initials: F
authors.lastname: Petrella
authors.forename: A
authors.initials: A
authors.lastname: Borri
authors.forename: M
authors.initials: M
authors.lastname: Casiraghi
authors.forename: R
authors.initials: R
authors.lastname: Bertolotti
authors.forename: N
authors.initials: N
authors.lastname: Rotmensz
authors.forename: M
authors.initials: M
authors.lastname: Bellomi