Background The outcome among patients with clinical stage Icancer that is detected on annual screening using spiral computedtomography (CT) is unknown.
Methods In a large collaborative study, we screened 31,567 asymptomaticpersons at risk for lung cancer using low-dose CT from 1993through 2005, and from 1994 through 2005, 27,456 repeated screeningswere performed 7 to 18 months after the previous screening.We estimated the 10-year lung-cancer–specific survivalrate among participants with clinical stage I lung cancer thatwas detected on CT screening and diagnosed by biopsy, regardlessof the type of treatment received, and among those who underwentsurgical resection of clinical stage I cancer within 1 month.A pathology panel reviewed the surgical specimens obtained fromparticipants who underwent resection.
Results Screening resulted in a diagnosis of lung cancer in484 participants. Of these participants, 412 (85%) had clinicalstage I lung cancer, and the estimated 10-year survival ratewas 88% in this subgroup (95% confidence interval [CI], 84 to91). Among the 302 participants with clinical stage I cancerwho underwent surgical resection within 1 month after diagnosis,the survival rate was 92% (95% CI, 88 to 95). The 8 participantswith clinical stage I cancer who did not receive treatment diedwithin 5 years after diagnosis.
Conclusions Annual spiral CT screening can detect lung cancerthat is curable.
Source Information
The members of the Writing Committee (Claudia I. Henschke, M.D., Ph.D., David F. Yankelevitz, M.D., Daniel M. Libby, M.D., Mark W. Pasmantier, M.D., and James P. Smith, M.D., New York Presbyterian Hospital–Weill Medical College of Cornell University, New York; and Olli S. Miettinen, M.D., Ph.D., McGill University, Montreal) of the International Early Lung Cancer Action Program assume responsibility for the overall content and integrity of the article.
Address reprint requests to Dr. Henschke at New York Presbyterian Hospital–Weill Medical College of Cornell University, 525 E. 168th St., New York, NY 10021, or at chensch{at}med.cornell.edu.
CT Screening for Lung Cancer
Gould M. K., Berg C. D., Aberle D. R., the National Lung Screening Trial Executive Committee , Bach P. B., Kulaga S., Karp I., Yee A. J., Lynch T. J., Silvestri G. A., Miller A., Markowitz S., Miller J. A., Lee P., Postmus P. E., Sutedja T. G., Dehavenon A., Henschke C. I., Smith J. P., Miettinen O. S.
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N Engl J Med 2007;
356:743-747, Feb 15, 2007.
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A correction has been published: N Engl J Med 2008;358(17):1862.
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