Researchers have shown that low-dose spiral computer-based tomographic (CT) screening for the early detection of lung cancer can lead to an early diagnosis in a high proportion of cases, potentially increasing the chances for a cure.

Spanish investigators pointed out that after the initial screening with CT, a possible second step included positron emission tomography (PET) for nodules detected by computerized tomography that were 10 mm or larger, along with smaller growing nodules over 7 mm in size.

Both detection steps were designed to help minimize unnecessary invasive procedures for benign lesions.

According to the authors, lung cancer is one of the leading causes of death in the world. In many countries, it is the most common cancer and the most lethal because the majority of patients are diagnosed in late stages of disease. Less than 20 percent of individuals who suffer from this illness are diagnosed in stages in which curative surgery is an option. The survival rates for early stage disease are quite high, approaching 80 percent in some series. However, the overall survival rates at 5 years are approximately 15 percent.

At the start of the study, all patients who participated were characterized as high risk for lung cancer. Their mean age was 54.7 years, and their median tobacco consumption was 30 pack years.

In the study, lung cancer was detected in 14 patients out of 911 individuals in the protocol. There were 13 non-small cell lung cancers and one small cell lung cancer. Eleven of the 13 non-small cell lung cancers and the one small cell lung case were detected on the initial CT screening.

.All patients with non-small cell lung cancer underwent surgery because they had been diagnosed with stage 1 disease. There were no preoperative surgical biopsies performed. Fine needle aspiration was performed on four PET-positive nodules and two growing PET negative nodules.

The study is published in the second issue for June 2005 of the ATS peer-reviewed American Journal of Respiratory and Critical Care Medicine.

American Thoracic Society journal news tips for June 2005 (second issue)

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