Lung cancer is the leading cause of death from cancer amongmen and women in the United States. More people die each yearof lung cancer than of colon, breast, and prostate cancer combined.Despite new diagnostic techniques, the overall five-year survivalrates remain about 14 percent, and most patients still presentwith advanced disease.1
There has long been interest in screening to detect lung cancerswhen they are smaller and presumably at earlier and more curablestages, as witnessed by the support for previous screening trialsusing chest radiography and cytologic examination of sputum.Unfortunately, these studies failed to . . . [Full Text of this Article]
Some Fundamentals about Screening
Prior Screening Trials
Current Early-Detection and Screening Trials
Imaging Studies
Nonimaging Methods of Early Detection
Potential Biologic Limitations in Screening for Lung Cancer
Current Recommendations
Source Information
From the Department of Radiology, Duke University Medical Center, Durham, N.C. (E.F.P., P.C.G.); and the Departments of Medicine and Cancer Genetics, Roswell Park Cancer Institute, Buffalo, N.Y. (G.B.).
Address reprint requests to Dr. Patz at the Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC 27710, or at patz0002@mc.duke.edu.
References
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(2009). Immunodetection of DNA Repair Endonuclease ERCC1-XPF in Human Tissue. Cancer Res.
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[Abstract][Full Text]
Infante, M., Cavuto, S., Lutman, F. R., Brambilla, G., Chiesa, G., Ceresoli, G., Passera, E., Angeli, E., Chiarenza, M., Aranzulla, G., Cariboni, U., Errico, V., Inzirillo, F., Bottoni, E., Voulaz, E., Alloisio, M., Destro, A., Roncalli, M., Santoro, A., Ravasi, G., for the DANTE Study Group,
(2009). A Randomized Study of Lung Cancer Screening with Spiral Computed Tomography: Three-year Results from the DANTE Trial. Am. J. Respir. Crit. Care Med.
180: 445-453
[Abstract][Full Text]
Douglas, P. S., Taylor, A., Bild, D., Bonow, R., Greenland, P., Lauer, M., Peacock, F., Udelson, J.
(2009). Outcomes Research in Cardiovascular Imaging: Report of a Workshop Sponsored by the National Heart, Lung, and Blood Institute. J Am Coll Cardiol Img
2: 897-907
[Abstract][Full Text]
Douglas, P. S., Taylor, A., Bild, D., Bonow, R., Greenland, P., Lauer, M., Peacock, F., Udelson, J.
(2009). Outcomes Research in Cardiovascular Imaging: Report of a Workshop Sponsored by the National Heart, Lung, and Blood Institute. Circ Cardiovasc Imaging
2: 339-348
[Abstract][Full Text]
Lauer, M. S.
(2009). Discarding Logic: 2008 Ancel Keys Memorial Lecture. Circulation
119: 1533-1537
[Full Text]
Byrne, M. M., Weissfeld, J., Roberts, M. S.
(2008). Anxiety, Fear of Cancer, and Perceived Risk of Cancer following Lung Cancer Screening. Med Decis Making
28: 917-925
[Abstract]
McMahon, P. M., Kong, C. Y., Johnson, B. E., Weinstein, M. C., Weeks, J. C., Kuntz, K. M., Shepard, J.-A. O., Swensen, S. J., Gazelle, G. S.
(2008). Estimating Long-term Effectiveness of Lung Cancer Screening in the Mayo CT Screening Study. Radiology
248: 278-287
[Abstract][Full Text]
Ravenel, J. G., Costello, P., Silvestri, G. A.
(2008). Screening for Lung Cancer. Am. J. Roentgenol.
190: 755-761
[Abstract][Full Text]
Patz, E. F. Jr, Campa, M. J., Gottlin, E. B., Kusmartseva, I., Guan, X. R., Herndon, J. E. II
(2007). Panel of Serum Biomarkers for the Diagnosis of Lung Cancer. JCO
25: 5578-5583
[Abstract][Full Text]
Greenberg, A. K., Rimal, B., Felner, K., Zafar, S., Hung, J., Eylers, E., Phalan, B., Zhang, M., Goldberg, J. D., Crawford, B., Rom, W. N., Naidich, D., Merali, S.
(2007). S-Adenosylmethionine as a Biomarker for the Early Detection of Lung Cancer. Chest
132: 1247-1252
[Abstract][Full Text]
Miller, Y. E., Keith, R. L.
(2007). Inhaled Corticosteroids and Lung Cancer Chemoprevention. Am. J. Respir. Crit. Care Med.
175: 636-637
[Full Text]
Okada, M., Mimura, T., Ikegaki, J., Katoh, H., Itoh, H., Tsubota, N.
(2007). A novel video-assisted anatomic segmentectomy technique: Selective segmental inflation via bronchofiberoptic jet followed by cautery cutting. J. Thorac. Cardiovasc. Surg.
133: 753-758
[Abstract][Full Text]
Mujoomdar, A., Austin, J. H. M., Malhotra, R., Powell, C. A., Pearson, G. D. N., Shiau, M. C., Raftopoulos, H.
(2007). Clinical Predictors of Metastatic Disease to the Brain from Non-Small Cell Lung Carcinoma: Primary Tumor Size, Cell Type, and Lymph Node Metastases. Radiology
242: 882-888
[Abstract][Full Text]
Schoder, H., Gonen, M.
(2007). Screening for Cancer with PET and PET/CT: Potential and Limitations. JNM
48: 4S-18S
[Abstract][Full Text]
Okada, M., Koike, T., Higashiyama, M., Yamato, Y., Kodama, K., Tsubota, N.
(2006). Radical sublobar resection for small-sized non small cell lung cancer: A multicenter study. J. Thorac. Cardiovasc. Surg.
132: 769-775
[Abstract][Full Text]
Holford, T. R., Cronin, K. A., Mariotto, A. B., Feuer, E. J.
(2006). Chapter 4: Changing Patterns in Breast Cancer Incidence Trends. J Natl Cancer Inst Monogr
2006: 19-25
[Abstract][Full Text]
Das, P., Ng, A. K., Earle, C. C., Mauch, P. M., Kuntz, K. M.
(2006). Computed tomography screening for lung cancer in Hodgkin's lymphoma survivors: decision analysis and cost-effectiveness analysis. Ann Oncol
17: 785-793
[Abstract][Full Text]
Reich, J. M.
(2006). Assessing the Efficacy of Lung Cancer Screening. Radiology
238: 398-401
[Full Text]
MacRedmond, R, McVey, G, Lee, M, Costello, R W, Kenny, D, Foley, C, Logan, P M, on behalf of the PALCAD investigators,
(2006). Screening for lung cancer using low dose CT scanning: results of 2 year follow up. Thorax
61: 54-56
[Abstract][Full Text]
Olson, R. P., Stone, A., Lubarsky, D.
(2005). The Prevalence and Significance of Low Preoperative Hemoglobin in ASA 1 or 2 Outpatient Surgery Candidates. Anesth. Analg.
101: 1337-1340
[Abstract][Full Text]
Flieder, D. B., Port, J. L., Korst, R. J., Christos, P. J., Levin, M. A., Becker, D. E., Altorki, N. K.
(2005). Tumor Size Is a Determinant of Stage Distribution in T1 Non-Small Cell Lung Cancer. Chest
128: 2304-2308
[Abstract][Full Text]
Lauer, M., Froelicher, E. S., Williams, M., Kligfield, P.
(2005). Exercise Testing in Asymptomatic Adults: A Statement for Professionals From the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Circulation
112: 771-776
[Abstract][Full Text]
Gazelle, G. S., McMahon, P. M., Siebert, U., Beinfeld, M. T.
(2005). Cost-effectiveness Analysis in the Assessment of Diagnostic Imaging Technologies. Radiology
235: 361-370
[Abstract][Full Text]
Kelley, M. J., Glaser, E. M., Herndon, J. E. II, Becker, F., Bhagat, R., Zhang, Y.-J., Santella, R. M., Carmella, S. G., Hecht, S. S., Gallot, L., Schilder, L., Crowell, J. A., Perloff, M., Folz, R. J., Bergan, R. C.
(2005). Safety and Efficacy of Weekly Oral Oltipraz in Chronic Smokers. Cancer Epidemiol. Biomarkers Prev.
14: 892-899
[Abstract][Full Text]
Grannis, F. W.
(2005). Overestimation of Lung Cancer Mortality in a Computed Tomography-Screened Population. JCO
23: 2439-2440
[Full Text]
Patz, E. F. Jr, Swensen, S. J., Herndon, J. E. II
(2005). In Reply:. JCO
23: 2440-2441
[Full Text]
Yankelevitz, D., Wisnivesky, J. P., Henschke, C. I.
(2005). Stage of Lung Cancer in Relation to Its Size: Part 1. Insights. Chest
127: 1132-1135
[Full Text]
Strauss, G. M., Dominioni, L., Jett, J. R., Freedman, M., Grannis, F. W. Jr
(2005). Como International Conference Position Statement: Lung Cancer Screening for Early Diagnosis 5 Years After The 1998 Varese Conference. Chest
127: 1146-1151
[Abstract][Full Text]
Buccheri, G., Ferrigno, D.
(2004). Lung cancer: clinical presentation and specialist referral time. Eur Respir J
24: 898-904
[Abstract][Full Text]
Lafata, J. E., Simpkins, J., Lamerato, L., Poisson, L., Divine, G., Johnson, C. C.
(2004). The Economic Impact of False-Positive Cancer Screens. Cancer Epidemiol. Biomarkers Prev.
13: 2126-2132
[Abstract][Full Text]
Patz, E. F. Jr, Swensen, S. J., Herndon, J. E. II
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[Abstract][Full Text]
Humphrey, L. L., Teutsch, S., Johnson, M.
(2004). Lung Cancer Screening with Sputum Cytologic Examination, Chest Radiography, and Computed Tomography: An Update for the U.S. Preventive Services Task Force. ANN INTERN MED
140: 740-753
[Abstract][Full Text]
MacRedmond, R, Logan, P M, Lee, M, Kenny, D, Foley, C, Costello, R W
(2004). Screening for lung cancer using low dose CT scanning. Thorax
59: 237-241
[Abstract][Full Text]
Pfister, D. G., Johnson, D. H., Azzoli, C. G., Sause, W., Smith, T. J., Baker, S. Jr, Olak, J., Stover, D., Strawn, J. R., Turrisi, A. T., Somerfield, M. R.
(2004). American Society of Clinical Oncology Treatment of Unresectable Non-Small-Cell Lung Cancer Guideline: Update 2003. JCO
22: 330-353
[Full Text]
Koh, T. J., Field, J. K., Varro, A., Liloglou, T., Fielding, P., Cui, G., Houghton, J., Dockray, G. J., Wang, T. C.
(2004). Glycine-Extended Gastrin Promotes the Growth of Lung Cancer. Cancer Res.
64: 196-201
[Abstract][Full Text]
Fenton, J. J., Deyo, R. A.
(2003). Patient Self-Referral for Radiologic Screening Tests: Clinical and Ethical Concerns. J Am Board Fam Med
16: 494-501
[Abstract][Full Text]
Castaldo, G., Tomaiuolo, R., Sanduzzi, A., Ponticiello, A., Marchetiello, I., Salvatore, F.
(2003). Carcinoembryonic antigen mRNA analysis detects micrometastatic cells in blood from lung cancer patients. Eur Respir J
22: 418-421
[Abstract][Full Text]
Manser, R L, Irving, L B, Byrnes, G, Abramson, M J, Stone, C A, Campbell, D A
(2003). Screening for lung cancer: a systematic review and meta-analysis of controlled trials. Thorax
58: 784-789
[Abstract][Full Text]
Mark, D. B., Shaw, L. J., Lauer, M. S., O'Malley, P. G., Heidenreich, P.
(2003). Task force #5--is atherosclerosis imaging cost effective?. J Am Coll Cardiol
41: 1906-1917
[Full Text]
Bach, P. B., Kattan, M. W., Thornquist, M. D., Kris, M. G., Tate, R. C., Barnett, M. J., Hsieh, L. J., Begg, C. B.
(2003). Variations in Lung Cancer Risk Among Smokers. JNCI J Natl Cancer Inst
95: 470-478
[Abstract][Full Text]
Mahadevia, P. J., Fleisher, L. A., Frick, K. D., Eng, J., Goodman, S. N., Powe, N. R.
(2003). Lung Cancer Screening With Helical Computed Tomography in Older Adult Smokers: A Decision and Cost-effectiveness Analysis. JAMA
289: 313-322
[Abstract][Full Text]
Quarterman, R. L., McMillan, A., Ratcliffe, M. B., Block, M. I.
(2003). Effect of preoperative delay on prognosis for patients with early stage non-small cell lung cancer. J. Thorac. Cardiovasc. Surg.
125: 108-114
[Abstract][Full Text]
Sutedja, G.
(2003). New techniques for early detection of lung cancer. Eur Respir J
21: 57S-66s
[Abstract][Full Text]
Bach, P. B., Kelley, M. J., Tate, R. C., McCrory, D. C.
(2003). Screening for Lung Cancer: A Review of the Current Literature. Chest
123
: 72S-82S
[Abstract][Full Text]
Spiro, S. G., Porter, J. C.
(2002). Lung Cancer--Where Are We Today?: Current Advances in Staging and Nonsurgical Treatment. Am. J. Respir. Crit. Care Med.
166: 1166-1196
[Abstract][Full Text]
Garg, K., Keith, R. L., Byers, T., Kelly, K., Kerzner, A. L., Lynch, D. A., Miller, Y. E.
(2002). Randomized Controlled Trial with Low-Dose Spiral CT for Lung Cancer Screening: Feasibility Study and Preliminary Results. Radiology
225: 506-510
[Abstract][Full Text]
Berlin, L.
(2002). Liability of Performing CT Screening for Coronary Artery Disease and Lung Cancer. Am. J. Roentgenol.
179: 837-842
[Full Text]
Clegg, L. X., Li, F. P., Hankey, B. F., Chu, K., Edwards, B. K.
(2002). Cancer Survival Among US Whites and Minorities: A SEER (Surveillance, Epidemiology, and End Results) Program Population-Based Study. Arch Intern Med
162: 1985-1993
[Abstract][Full Text]
Rusch, V. W.
(2002). High-resolution computed tomography in clinical T1 N0 M0 adenocarcinoma of the lung. J. Thorac. Cardiovasc. Surg.
124: 221-222
[Full Text]
Marcus, P. M.
(2002). Lung Cancer Screening, Once Again. Chest
122: 3-4
[Full Text]
Reich, J. M.
(2002). Improved Survival and Higher Mortality* : The Conundrum of Lung Cancer Screening. Chest
122: 329-337
[Full Text]
Lopez-Encuentra, A., Duque-Medina, J. L., Rami-Porta, R., de la Camara, A. G., Ferrando, P.
(2002). Staging in Lung Cancer: Is 3 cm a Prognostic Threshold in Pathologic Stage I Non-small Cell Lung Cancer? : A Multicenter Study of 1,020 Patients. Chest
121: 1515-1520
[Abstract][Full Text]
Strauss, G. M.
(2002). The Mayo Lung Cohort: A Regression Analysis Focusing on Lung Cancer Incidence and Mortality. JCO
20: 1973-1983
[Abstract][Full Text]
Hollings, N., Shaw, P.
(2002). Diagnostic imaging of lung cancer. Eur Respir J
19: 722-742
[Abstract][Full Text]
Ciment, L. M., Ciment, A. J.
(2002). Malignant Ameloblastoma Metastatic to the Lungs 29 Years After Primary Resection* : A Case Report. Chest
121: 1359-1361
[Abstract][Full Text]
Friedenberg, R. M.
(2002). The 21st Century: The Age of Screening. Radiology
223: 1-4
[Full Text]
Turkington, P M, Kennan, N, Greenstone, M A
(2002). Misinterpretation of the chest x ray as a factor in the delayed diagnosis of lung cancer. Postgrad. Med. J.
78: 158-160
[Abstract][Full Text]
Lee, T. H., Brennan, T. A.
(2002). Direct-to-Consumer Marketing of High-Technology Screening Tests. NEJM
346: 529-531
[Full Text]
Kodama, K., Higashiyama, M., Yokouchi, H., Takami, K., Kuriyama, K., Kusunoki, Y., Nakayama, T., Imamura, F.
(2002). Natural history of pure ground-glass opacity after long-term follow-up of more than 2 years. Ann. Thorac. Surg.
73: 386-392
[Abstract][Full Text]
Schaefer-Prokop, C., Prokop, M.
(2002). New imaging techniques in the treatment guidelines for lung cancer. Eur Respir J
19: 71S-83s
[Abstract][Full Text]
Ramnath, N., Hernandez, F. J., Tan, D.-F., Huberman, J. A., Natarajan, N., Beck, A. F., Hyland, A., Todorov, I. T., Brooks, J. S.J., Bepler, G.
(2001). MCM2 Is an Independent Predictor of Survival in Patients With Non-Small-Cell Lung Cancer. JCO
19: 4259-4266
[Abstract][Full Text]
van Klaveren, R.J., Habbema, J.D.F., Pedersen, J.H., de Koning, H.J., Oudkerk, M., Hoogsteden, H.C.
(2001). Lung cancer screening by low-dose spiral computed tomography. Eur Respir J
18: 857-866
[Abstract][Full Text]
Austin, J. H.M., Stellman, S. D., Pearson, G. D.N., Miettinen, O. S., Yankelevitz, D. F., Henschke, C. I., Mulshine, J. L., Day, R. W., Patz, E. F., Goodman, P. C., Bepler, G.
(2001). Screening for Lung Cancer. NEJM
344: 935-936
[Full Text]
Diederich, S., Wormanns, D., Semik, M., Thomas, M., Lenzen, H., Roos, N., Heindel, W.
(2002). Screening for Early Lung Cancer with Low-Dose Spiral CT: Prevalence in 817 Asymptomatic Smokers. Radiology
222: 773-781
[Abstract][Full Text]