CT screening for lung cancer Assessing a regimen's diagnostic performance.
ABSTRACT The purpose of this study was to characterize the diagnostic performance of a regimen of CT screening for lung cancer.
Using a common protocol/regimen of screening, 2968 asymptomatic persons at high risk for lung cancer were enrolled in two studies [Early Lung Cancer Action Projects (ELCAP) I and II] for baseline and annual repeat screening. A total of 4538 annual repeat screenings were performed. The regimen's diagnostic performance was characterized in terms of frequency of positive result of the initial CT as well as of screen-diagnosis and Stage I screen-diagnosis among all diagnoses (interim-diagnoses included), all separately for baseline and annual repeat screenings.
The proportions with positive result of the initial CT were 12% and 6% in the baseline and repeat screenings, respectively. The proportions of screen-diagnoses among all diagnoses (interim-diagnoses included) were 97% and 99% in the baseline and repeat cycles, respectively. The corresponding proportions of pre-surgical Stage I screen-diagnoses were 95% and 93%.
The performance of the ELCAP regimen is quite satisfactory in avoiding over many positive results of the initial CT, and it produces highly promising diagnostic results as for the attainment of cure by early intervention.
- New England Journal of Medicine 07/2005; 352(26):2714-20. DOI:10.1056/NEJMcp042630 · 54.42 Impact Factor
Article: Lung cancer screening.[Show abstract] [Hide abstract]
ABSTRACT: Advances in imaging technologies and biomarker research offer hope that the incidence and mortality of lung cancer can be reduced by screening similar to what have been achieved for cancer of the cervix, breast, and colon. Spiral computed tomography with multitrack scanners and autofluorescence bronchoscopy offer unprecedented sensitivity to detect lung cancer even during the preinvasive stage. The high sensitivity of these tests, however, is associated with a low specificity. Better selection of individuals at highest risk of lung cancer using biomarkers in sputum, blood, or exhaled breath, as well as a better understanding of genetic susceptibility, may improve their positive predictive values, minimize unnecessary downstream investigations or treatment, as well as reduce screening costs. Improvement in the performance of sputum, exhaled breath, or blood biomarkers holds promise as the first screening step to identify individuals at highest risk of lung cancer beyond what age and smoking could predict to select those who would obtain the most benefits from spiral computed tomography or autofluorescence bronchoscopy as localization tools.Current opinion in pulmonary medicine 08/2005; 11(4):272-7. DOI:10.1097/01.mcp.0000166592.10666.d1 · 2.96 Impact Factor
- Journal of Thoracic Imaging 12/2005; 20(4):324-5. · 1.49 Impact Factor