The Pittsburgh Lung Screening Study (PLuSS): outcomes within 3 years of a first computed tomography scan.

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15232, USA.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 11.99). 11/2008; 178(9):956-61. DOI: 10.1164/rccm.200802-336OC
Source: PubMed

ABSTRACT The role of computed tomography (CT) screening for lung cancer is controversial, currently under study, and not yet fully elucidated.
To report findings from initial and 1-year repeat screening low-radiation-dose CT of the chest and 3-year outcomes for 50- to 79-year-old current and ex-smokers in the Pittsburgh Lung Screening Study (PLuSS).
Notified of findings on screening CT, subjects received diagnostic advice from both study and personal physicians. Tracking subjects for up to three years since initial screening, we obtained medical records to document diagnostic procedures, lung cancer diagnoses, and deaths.
3,642 and 3,423 subjects had initial and repeat screening. A total of 1,477 (40.6% of 3,624) were told about noncalcified lung nodules on the initial screening and, before repeat screening, 821 (55.6% of 1,477, 22.5% of 3,642) obtained one or more subsequent diagnostic imaging studies (CT, positron emission tomography [PET], or PET-CT). Tracking identified 80 subjects with lung cancer, including 53 subjects with tumor seen at initial screening. In all, 36 subjects (1.0% of the 3,642 screened), referred for abnormalities on either the initial or repeat screening, had a major thoracic surgical procedure (thoracotomy, video-assisted thoracoscopic surgery [VATS], median sternotomy, or mediastinoscopy) leading to a noncancer final diagnosis. Out of 82 subjects with thoracotomy or VATS to exclude malignancy in a lung nodule, 28 (34.1%) received a noncancer final diagnosis. Forty of 69 (58%) subjects with non-small cell lung cancer had stage I disease at diagnosis.
Though leading to the discovery of early stage lung cancer, CT screening also led to many diagnostic follow-up procedures, including major thoracic surgical procedures with noncancer outcomes.

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Available from: David O Wilson, Jul 17, 2015
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    • "A recent survey of individuals with a high risk for developing lung cancer by the National Institutes of Health demonstrated that the patients screened through low-dose helical computed tomography (CT) had a 20% lower mortality rate than those screened by a traditional chest x-ray, presumably due to the improved image quality associated with the CT (Aberle et al. 2011). However, the relatively high cost of the helical CT, a limited access to this technology in some geographical areas, and problems of differentiating benign pulmonary nodules from lung cancer (Welch et al. 2007; Wilson et al. 2008), leading to higher-than-desired false-positive rates, have limited its widespread use. Molecular tests based on glycoconjugate measurements have also been developed to identify potential markers of lung cancer (Heo et al. 2007; Ueda et al. 2009; Zeng et al. 2010; Arnold et al. 2011). "
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