Survival of Patients With Stage I Lung Cancer Detected on CT Screening

N Engl J Med. 2006 Oct 26;355(17):1763-71. doi: 10.1056/NEJMoa060476.

Abstract

Background: The outcome among patients with clinical stage I cancer that is detected on annual screening using spiral computed tomography (CT) is unknown.

Methods: In a large collaborative study, we screened 31,567 asymptomatic persons at risk for lung cancer using low-dose CT from 1993 through 2005, and from 1994 through 2005, 27,456 repeated screenings were performed 7 to 18 months after the previous screening. We estimated the 10-year lung-cancer-specific survival rate among participants with clinical stage I lung cancer that was detected on CT screening and diagnosed by biopsy, regardless of the type of treatment received, and among those who underwent surgical resection of clinical stage I cancer within 1 month. A pathology panel reviewed the surgical specimens obtained from participants who underwent resection.

Results: Screening resulted in a diagnosis of lung cancer in 484 participants. Of these participants, 412 (85%) had clinical stage I lung cancer, and the estimated 10-year survival rate was 88% in this subgroup (95% confidence interval [CI], 84 to 91). Among the 302 participants with clinical stage I cancer who underwent surgical resection within 1 month after diagnosis, the survival rate was 92% (95% CI, 88 to 95). The 8 participants with clinical stage I cancer who did not receive treatment died within 5 years after diagnosis.

Conclusions: Annual spiral CT screening can detect lung cancer that is curable.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Biopsy
  • Carcinoma / diagnostic imaging*
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Case-Control Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Lung / diagnostic imaging*
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Occupational Exposure / adverse effects
  • Smoking / adverse effects
  • Survival Rate
  • Tobacco Smoke Pollution / adverse effects
  • Tomography, X-Ray Computed*

Substances

  • Tobacco Smoke Pollution