A case-control study of lung cancer screening in Okayama Prefecture, Japan

Nishii, Kenji; Ueoka, Hiroshi; Kiura, Katsuyuki; Kodani, Tsuyoshi; Tabata, Masahiro; Shibayama, Takuo; Gemba, Kenichi; Kitajima, Takuji; Hiraki, Akio; Kawaraya, Masashi; Nakayama, Tomio; Harada, Mine

doi:10.1016/s0169-5002(01)00270-7

Cited by 53 publications

(10 citation statements)

References 21 publications

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“…Here we analyze the LC detection results and the LC survival rates at community level, in the setting of CXR screening offered to a clearly defined population-based cohort of smokers. Only 21% of this cohort participated in screening, a low attendance rate similar to that observed in mass screening for LC in Japan [29,30]. Analyzing the demographic features and risk factors of the whole screening-invited cohort, we previously reported that participation was possibly prompted by increased awareness of LC risk, while it was not related to educational level [17].…”

Section: Discussionmentioning

confidence: 94%

A population-based cohort study of chest x-ray screening in smokers: lung cancer detection findings and follow-up

et al. 2012

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BackgroundCase-control studies of mass screening for lung cancer (LC) by chest x-rays (CXR) performed in the 1990s in scarcely defined Japanese target populations indicated significant mortality reductions, but these results are yet to be confirmed in western countries. To ascertain whether CXR screening decreases LC mortality at community level, we studied a clearly defined population-based cohort of smokers invited to screening. We present here the LC detection results and the 10-year survival rates.MethodsThe cohort of all smokers of > 10 pack-years resident in 50 communities of Varese, screening-eligible (n = 5,815), in July 1997 was invited to nonrandomized CXR screening. Self-selected participants (21% of cohort) underwent screening in addition to usual care; nonparticipants received usual care. The cohort was followed-up until December 2010. Kaplan-Meier LC-specific survival was estimated in participants, in nonparticipants, in the whole cohort, and in an uninvited, unscreened population (control group).ResultsOver the initial 9.5 years of study, 67 LCs were diagnosed in screening participants (51% were screen-detected) and 178 in nonparticipants. The rates of stage I LC, resectability and 5-year survival were nearly twice as high in participants (32% stage I; 48% resected; 30.5% 5-year survival) as in nonparticipants (17% stage I; 27% resected; 13.5% 5-year survival). There were no bronchioloalveolar carcinomas among screen-detected cancers, and median volume doubling time of incidence screen-detected LCs was 80 days (range, 44-318), suggesting that screening overdiagnosis was minimal. The 10-year LC-specific survival was greater in screening participants than in nonparticipants (log-rank, p = 0.005), and greater in the whole cohort invited to screening than in the control group (log-rank, p = 0.001). This favourable long-term effect was independently related to CXR screening exposure.ConclusionIn the setting of CXR screening offered to a population-based cohort of smokers, screening participants who were diagnosed with LC had more frequently early-stage resectable disease and significantly enhanced long-term LC survival. These results translated into enhanced 10-year LC survival, independently related to CXR screening exposure, in the entire population-based cohort. Whether increased long-term LC-specific survival in the cohort corresponds to mortality reduction remains to be evaluated.Trial registration numberISRCTN90639073

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Section: Discussionmentioning

confidence: 94%

A population-based cohort study of chest x-ray screening in smokers: lung cancer detection findings and follow-up

et al. 2012

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“…Community‐based lung cancer screening using chest radiography is well established in Japan . Japanese residents who are 40 years or older can undergo annual chest radiography.…”

Section: Methodsmentioning

confidence: 99%

Detection of chronic obstructive pulmonary disease in community‐based annual lung cancer screening: Chiba Chronic Obstructive Pulmonary Disease Lung Cancer Screening Study Group

Sekine

Fujisawa²,

Suzuki³

et al. 2013

Respirology

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“…An annual mass screening program for lung cancer has been conducted since 1982 in Japan, including annual chest X‐ray examinations for those aged 40 or over, and added sputum cytology for individuals aged 50 or over with a smoking history of over 30 pack‐years and those aged 40 or over with a history of bloody sputum within the previous 6 months. For individuals suspected to have lung cancer on chest X‐ray or sputum cytology, further examinations were performed to confirm the diagnosis 6–8.…”

Section: Introductionmentioning

confidence: 99%