Screening for lung cancer. The Mayo Lung Project revisited

Cancer. 1993 Sep 1;72(5):1573-80. doi: 10.1002/1097-0142(19930901)72:5<1573::aid-cncr2820720514>3.0.co;2-9.

Abstract

Background: The Mayo Lung Project (MLP) reported lung cancer incidence and mortality in a population offered chest radiographs and sputum cytologic screening examinations every 4 months and a population offered only the Mayo Clinic advice to undergo annual examination. No mortality benefit attributable to screening was observed after 6 years of observation and at least 1 year of follow-up.

Methods: The authors describe a simulation study designed to estimate from Mayo data the parameters in a mathematical model of the natural history of lung cancer and to estimate the potential benefit associated with periodic screening of high-risk people starting at 45 years of age.

Results: It was found that the mean duration of Stage I non-small cell lung cancer is at least 4 years and that rates of Stage I detectability and curability are less than 25% and 35%, respectively.

Conclusions: A trial of the magnitude, duration, and contamination of the MLP would have a less than 20% probability of showing significant benefit from screening; however, long-term annual screening might result in a modest decrease in lung cancer mortality, ranging from 0% to 13%. A greater benefit would accrue from improved detection and treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / prevention & control*
  • Cause of Death
  • Computer Simulation
  • Follow-Up Studies
  • Humans
  • Life Expectancy
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / prevention & control*
  • Male
  • Mass Screening*
  • Middle Aged
  • Minnesota / epidemiology
  • Models, Biological
  • Neoplasm Staging
  • Prevalence
  • Probability
  • Radiography, Thoracic
  • Sputum / cytology
  • Survival Rate