Abstract
Figures and Tables
Table 1
Randomized Controlled Trials of Lung Cancer Screening with Low-Dose CT
![jksr-73-137-i001](/upload/SynapseData/ArticleImage/2016jksr/jksr-73-137-i001.jpg)
Study | Years of Recruitment | Sex | Age | Participants (Baseline) | Smoking History | Screening Schedule (Years)‡ | Total Follow-Up Period | Lung Cancer at Initial (Total in Follow-Up) |
---|---|---|---|---|---|---|---|---|
NLST (13) USA |
2002-2004 | Male 59% | 55-74 | LDCT arm: 26722 | Current or Ex-smokers ≥ 30 PY, quit < 15 years | 0, 1, 2 | 5 years | 1.1% (2.4%) |
Control arm (CXR): 26732 | ||||||||
DANTE (24) Italy |
2001-2006 | Male 100% | 60-74 | LDCT arm: 1276 | Current or Ex-smokers ≥ 20 PY | 0, 1, 2, 3, 4 | 4 years | 2.2% (4.7%) |
Control arm (clinic)*: 1196 | ||||||||
DLCST (25) Denmark |
2004-2006 | Male 55% | 50-70 | LDCT arm: 2052 | Current or Ex-smokers ≥ 20 PY, quit < 15 years | 0, 1, 2, 3, 4 | 10 years | 0.8% (3.4%) |
Control arm (usual care): 2052 | ||||||||
MILD (26) Italy |
2005-2011 | Male 66% | 49-75 | LDCT arm: 1190 (A)/1186 (B) | Current or Ex-smokers ≥ 20 PY, quit < 10 years | 0, 1, 2, 3, 4 (A) | 10 years | 0.8% (2.4%) |
Control arm (usual care): 1723 | 0, 2, 4 (B) | |||||||
NELSON (27, 28) Netherlands and Belgium |
2003-2006 | Male 83.5% | 50-74 | LDCT arm: 7915 | Current or Ex-smokers > 15 PY, quit < 10 years | 0, 1, 3 | 10 years | 0.9% (2.6%) |
Control arm (usual care): 7907 | ||||||||
ITALUNG (29, 30) Italy |
2004- | Male 64.7% | 55-69 | LDCT arm: 1613 | Current or Ex-smokers ≥ 20 PY, quit < 10 years | 0, 1, 2, 3, 4 | 4 years | 1.5% (2.8%) |
Control arm (usual care): 1593 | ||||||||
LUSI (31) Germany |
2007- | Male 64.7% | 50-69 | LDCT arm: 2029 | Current or Ex-smokers > 15 PY, quit < 10 years | 0, 1, 2, 3, 4 | 5 years | NA |
Control arm (usual care): 2023 | ||||||||
UKLS (32, 33) United Kingdom |
2011- | NA | 50-75 | LDCT arm: 2000† | 5% risk of developing lung cancer in 5 years (Liverpool Lung Project risk model) | 0 | 10 years | NA |
Control arm (usual care): 2000 |
*All participants received CXR + sputum cytology at baseline.
†Planned recruitment.
‡Screening schedule indicates which year the scans are performed with "0" indicating baseline scan.
A = annual, B = biennial, CXR = chest radiograph, DANTE = Detection and Screening of Early Lung Cancer by Novel Imaging Technology and Molecular Essays, DLCST = Danish Lung Cancer Screening Trials, ITALUNG = Italian Lung, LUSI = German Lung Cancer Screening Intervention Trial, MILD = Multicentric Italian Lung Detection, NA = not available, NELSON = Dutch-Belgian randomized lung cancer screening trial, NLST = National Lung Screening Trial, PY = pack-years, UKLS = United Kingdom Lung Screen
Table 2
Effects of Lung Cancer Screening with LDCT
![jksr-73-137-i002](/upload/SynapseData/ArticleImage/2016jksr/jksr-73-137-i002.jpg)
Study | Screen Methods | Participants | Persons-Year | Lung Cancer Deaths | Relative Risk (95% CI) | Overall Deaths | Relative Risk (95% CI) |
---|---|---|---|---|---|---|---|
NLST (14) | LDCT arm | 26722 | 144103 | 356 | 0.80 (0.70-0.92) | 1877 | 0.93 (0.88-0.99) |
Control arm | 26732 | 143368 | 443 | 2000 | |||
DANTE (24) | LDCT arm | 1276 | 3796 | 20 | 0.83 (0.45-1.53) | 46 | 0.85 (0.56-1.27) |
Control arm | 1196 | 3140 | 20 | 45 | |||
DLCST (25) | LDCT arm | 2052 | 9769 | 15 | 1.37 (0.63-2.97) | 61 | 1.46 (0.98-2.15) |
Control arm | 2052 | 9794 | 11 | 42 | |||
MILD (26) | LDCT arm | 2376 | 11073 | 18 | 1.50 (0.63-3.58) | 51 | 1.49 (0.89-2.49) |
1190 (annual) | |||||||
1186 (biennial) | |||||||
Control arm | 1723 | 6450 | 7 | 20 |
Table 3
Lung CT Screening Reporting and Data System (39)
![jksr-73-137-i003](/upload/SynapseData/ArticleImage/2016jksr/jksr-73-137-i003.jpg)
Table 4
![jksr-73-137-i004](/upload/SynapseData/ArticleImage/2016jksr/jksr-73-137-i004.jpg)
Stage | First Round, % | Second Round, % | Third Round, % |
---|---|---|---|
IA or IB | 54.6 | 59.1 | 63.9 |
IIIA, IIIB, or IV | 37.8 | 31.2 | 30.4 |
Table 5
Populations Recommended Lung Cancer Screening with Low-Dose CT
![jksr-73-137-i005](/upload/SynapseData/ArticleImage/2016jksr/jksr-73-137-i005.jpg)
Society | Primary Population | Other Populations |
---|---|---|
ACCP, ACS, KSTR, KMCC (15, 16, 22, 23) |
Aged 55-74 years ≥ 30 pack-year smoking Former smokers quit within past 15 years |
Not applicable |
USPSTF, ESR/ERS (19, 21) |
Aged 55-80 years ≥ 30 pack-year smoking Former smokers quit within past 15 years |
Not applicable |
NCCN (49) |
Aged 55-74 years ≥ 30 pack-year smoking Former smokers quit within past 15 years |
Aged ≥ 50 years ≥ 20 pack-year smoking Additional risk factors* |
AATS (18) |
Aged 55-79 years ≥ 30 pack-year smoking |
Aged ≥ 50 years ≥ 20 pack-year smoking Additional risk factors† or lung cancer survivors ≥ 5 years |
CMS (20) |
Aged 55-77 years ≥ 30 pack-year smoking Former smokers quit within past 15 years |
Not applicable |
*Cancer history, lung disease history, family history of lung cancer, radon exposure, and occupational exposure.
†Chronic obstructive pulmonary disease, environmental and occupational exposures, any prior cancer or thoracic radiation, and genetic or family history.
AATS = American Association for Thoracic Surgery, ACCP = American College of Chest Physicians, ACS = American Cancer Society, CMS = Centers for Medicare & Medicaid Service, ESR/ERS = European Society of Radiology/European Respiratory Society, KMCC = Korean multisociety collaborative committee, KSTR = Korean Society of Thoracic Radiology, NCCN = National Comprehensive Cancer Network, USPSTF = U.S. Preventive Service Task Services