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Annals of Oncology Advance Access published online on July 8, 2005
Annals of Oncology, doi:10.1093/annonc/mdi314
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© 2005 European Society for Medical Oncology
Received March 15, 2005
Revised May 11, 2005
Accepted June 6, 2005

Original article

Three-year findings of an early lung cancer detection feasibility study with low-dose spiral computed tomography in heavy smokers

S. Novello 1*, C. Fava 2, P. Borasio 3, L. Dogliotti 4, G. Cortese 2, B. Crida 1, G. Selvaggi 1, P. Lausi 3, M. P. Brizzi 4, P. Sperone 4, L. Cardinale 2, F. Ferraris 2, F. Perotto 2, A. Priola 2, and G. V. Scagliotti 1

1 University of Turin, Department of Clinical and Biological Sciences, Thoracic Oncology Unit, San Luigi Hospital, Orbassano (Turin), Italy
2 University of Turin, Department of Clinical and Biological Sciences, Division of Radiology, San Luigi Hospital, Orbassano (Turin), Italy
3 University of Turin, Department of Clinical and Biological Sciences, Division of Thoracic Surgery, San Luigi Hospital, Orbassano (Turin), Italy
4 University of Turin, Department of Clinical and Biological Sciences, Division of Medical Oncology, San Luigi Hospital, Orbassano (Turin), Italy

* To whom correspondence should be addressed.
S. Novello, E-mail: silvia.novello{at}tiscali.it


  Abstract

Background: Low-dose spiral computed tomography (sCT) showed a four-fold increase in the detection rate in high-risk subjects and a higher percentage of stage I lung cancer in comparison with chest X-ray. However, there is a considerable discrepancy among studies in the percentage of lung nodules, overall lung cancer and stage I detection rate.

Subjects and methods: From April to December 2001, 520 asymptomatic volunteers aged ≥55 years with a history of cigarette smoking ≥20 pack-years and no previous cancer were enrolled to receive an annual sCT of the chest for five consecutive years.

Results: Seventy three per cent were male, median age was 59 years and 91% were current smokers. At baseline, nodules ≥5 mm were detected in 114 (22%) undergoing sCT; the size of lung nodules ranged from 5 to 9.9 mm in 81.5% of the cases. Five (1%) cases of lung cancer were detected. In two additional cases a pathological diagnosis of atypical adenomatous hyperplasia was made. Three new cases of lung cancer were detected in the second and third year of the study. One interval case was detected during the third year.

Conclusions: Despite some promising data, convincing evidence from ongoing randomized trials is needed to support the routine use of sCT as a recommended tool for screening of lung cancer.

Keywords: early detection; lung cancer; spiral computed tomography scan.
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