Cancer Research Lab

Annual computed tomographic (CT) screening for lung cancer resulted in identification of a high proportion of patients with early-stage disease, researchers report in the April issue of Radiology

Principal investigator Dr. Claudia I. Henschke said that when conducting such screening “it is important to follow a well-defined and well-tested algorithm — or approach — which defines who needs further workup and what and when that workup should be done.”

The study appears after a study in the March 7, 2007 issue of JAMA that found no meaningful reduction in deaths from lung cancer due to CT screening. A much larger study of 50,000 people, sponsored by the National Cancer Institute, is now underway that researchers say will be more definitive.

In the current study, Dr. Henschke, of New York Presbyterian Hospital-Weill Cornell Medical Center, and colleagues studied 6295 subjects with a median age of 66 years and a median smoking history of 40 pack-years.

Initial CT imaging led to recommendations for further workup in 906 (14.4%) of the baseline screenings and 361 (6.0%) of the 6014 annual repeat screenings.

In total, 101 patients had a diagnosis of lung cancer following the baseline screening. Another 3 participants had such a diagnosis following symptoms which appeared before the repeat screening. In all, 95 (91.3%) of these patients had no evidence of metastasis.

In the 20 patients in whom the diagnosis of lung cancer was made following the repeat screening, 17 (85%) had no evidence of metastasis.

Of a total of 134 recommended biopsies, 125 (93.3%) resulted in the diagnosis of lung cancer or another malignancy.

“These figures are very similar to those with mammography screening and quality assurance of mammography screening has proven highly successful in providing early diagnosis and early treatment for breast cancer,” Dr. Henschke said.

“We have shown that we can diagnosis lung cancer early, early treatment of early lung cancer is usually curative,” she concluded.