CT screening for lung cancer: Diagnoses resulting from the New York Early Lung Cancer Action Project Journal Article
| Authors: | Henschke, C. I.; Yankelevitz, D. F.; McCauley, D. I.; Rifkin, M.; Fiore, E. S.; Austin, J. H. M.; Pearson, G. D. N.; Shiau, M. C.; Kopel, S.; Klippenstein, D.; Litwin, A.; Loud, P. A.; Kohman, L. J.; Scalzetti, E. M.; Khan, A.; Shah, R.; Mendelson, D. S.; Heelan, R. T.; Ginsberg, M. S.; Matalon, T. A. S.; Wiernik, P. H.; Altorki, N.; Farooqi, A.; Faustini, Y.; Libby, D. M.; Miettinen, O. S.; Ostroff, J.; Pasmantier, M. W.; Reeves, A. P.; Smith, J. P.; Vazquez, M. F.; Yip, R.; Agnello, K. K.; Kramer, A. L.; Hess, J. M.; Carter, D.; Brambilla, E.; Gazdar, A.; Noguchi, M.; Travis, W. D. |
| Article Title: | CT screening for lung cancer: Diagnoses resulting from the New York Early Lung Cancer Action Project |
| Abstract: | Purpose: To evaluate prospectively the diagnostic performance of the New York Early Lung Cancer Action Project (NY-ELCAP) regimen in the diagnosis of early lung cancer at baseline and annual repeat computed tomographic (CT) screenings. Materials and Methods: Informed consent and institutional review board approval were obtained for this HIPAA-compliant study of baseline and annual repeat low-dose CT screening performed with a common regimen in asymptomatic individuals at 12 institutions in New York State. All 6295 participants were aged 60 years or older, had smoked for at least 10 pack-years, had no prior cancer, had not undergone chest CT in the previous 3 years, and were medically fit to undergo thoracic surgery. Median age was 66 years, and median smoking history was 40 pack-years. The proportion (and 95% exact confidence intervals [Cls]) of subjects with a positive result, as determined by using nodule size; the diagnoses of lung cancer resulting from subsequent work-up; and the distribution by cancer stage and cell type were determined. When relevant, 95% CIs for the proportions were calculated. Results: Initial CT imaging led to recommendations for further work-up in 14.4% (95% CI: 13.5%, 15.3%) of the 6295 baseline screenings and 6.0% (95% CI: 5.1%, 6.6%) of the 6014 annual repeat screenings. Of 101 patients in whom the diagnosis of lung cancer resulted from baseline screening and three in whom a diagnosis of lung cancer was prompted by symptoms prior to the first scheduled repeat screening, 95 (91.3%) had no clinical evidence of metastases. Of the 20 patients whom the diagnosis of lung cancer resulted from annual repeat screening, 17 (85%) showed no evidence of metastases. Of the 134 recommended biopsies, 125 (93.3%) resulted in diagnosis of lung cancer or another malignancy, while none of the 24 biopsies performed outside of the recommendation of the regimen resulted in diagnosis of lung cancer. Conclusions: The NY-ELCAP regimen of screening revealed that annual CT screening for lung cancer, resulted in identification of a high proportion of patients with early-stage disease. © RSNA, 2007. |
| Keywords: | aged; major clinical study; cancer staging; lymphatic metastasis; neoplasm staging; diagnostic accuracy; prospective study; prospective studies; adenocarcinoma; metastasis; computer assisted tomography; cohort studies; lung neoplasms; cancer screening; lung cancer; mass screening; smoking; tomography, x-ray computed; clinical protocol; diagnostic imaging; time factors; cell type; confidence interval; diagnostic value; early diagnosis; positron-emission tomography; lung; calculation; lung nodule; thorax scintiscanning |
| Journal Title: | Radiology |
| Volume: | 243 |
| Issue: | 1 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2007-04-01 |
| Start Page: | 239 |
| End Page: | 249 |
| Language: | English |
| DOI: | 10.1148/radiol.2431060467 |
| PUBMED: | 17392256 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 38" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus" |
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