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LUNG CANCER |
1 Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
2 Department of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
3 Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland
Correspondence to:
Correspondence to:
Dr R E MacRedmond
Department of Medicine, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland; rmacredmond{at}rcsi.ie
Background: Screening with low dose chest computed tomographic scanning (LDCCT) may improve survival by identifying early asymptomatic lung cancer.
Methods: Four hundred and forty nine high risk subjects were screened with serial LDCCT scanning over 2 years. Fine needle aspiration biopsy was recommended for non-calcified nodules (NCNs) of >10 mm diameter or demonstrating interval growth.
Results: NCNs were identified in 111 subjects (24.7%), three of which were lung cancer. The overall prevalence (0.4%) and incidence (1.3%) rates of lung cancer detection were low. Three of the six lung cancers detected in the study were stage 1 non-small cell lung cancer; the remainder were unresectable central tumours. By contrast, eight subjects developed extrathoracic malignancy during the study period and other incidental pathology was noted in 221 subjects (49.2%). Smoking cessation rates at 19% were higher than in the general population, but 60.8% of subjects continued to smoke.
Conclusion: LDCCT scanning is useful in detecting early peripheral non-small cell lung cancers but its usefulness as a screening tool is limited by low specificity and by poor sensitivity for central tumours.
Abbreviations: FNAB, fine needle aspiration biopsy; LDCCT, low dose chest computed tomography; NCN, non-calcified nodule; NSCLC, non-small cell lung cancer
Keywords: smoking; lung cancer; screening; low dose CT scanning
Relevant Article
Thorax 2006 61: 1.
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