Baseline Chest Radiograph for Lung Cancer Detection in the Randomized Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Oken, Martin M.; Marcus, Pamela M.; Hu, Ping; Beck, Thomas M.; Hocking, William G.; Kvale, Paul A.; Cordes, Jill; Riley, Thomas L.; Winslow, Stephen D.; Peace, Steven; Levin, David L.; Prorok, Philip C.; Gohagan, John K.

doi:10.1093/jnci/dji430

Cited by 105 publications

(79 citation statements)

References 25 publications

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“…6). More importantly, CXR missed 20 (80%) of the 25 clinical stage I cancers, so that CXR screening was stopped.The baseline ELCAP CXR results are similar to those found in the Mayo Lung Project (MLP) [21] and to the recently reported baseline results of the Prostate, Lung, Colorectal, and Ovarian (PLCO) trial [22] (Fig. 6), which implies that the three cohorts had similar risk characteristics for lung cancer.…”

supporting

confidence: 84%

“…For colon cancer screening, new tests (e.g., colonoscopy and/or virtual colonoscopy with CT) have essentially replaced sigmoidoscopy, and the latter is used in the ongoing PLCO trial, but the efficacy of these new tests has not been tested using a randomized screening trial design. For lung cancer, CT was already available when the CXR and sputum trials were started in the mid 1980s, but CXR is still being tested in the PLCO trial [22, 62], and these results will not be reported in next decade. For coronary artery calcification screening with CT, no randomized trial has ever been performed, although large national cohort studies have been started.…”

Section: Advantages Of the Elcap Approachmentioning

confidence: 99%

“…The frequency of repeat diagnosis should be the same as that found in the absence of Figure 6. Percentage of baseline screen and interim diagnoses in ELCAP using CT and CXR as compared with baseline diagnoses in the MLP [21] and PLCO trial [22]. Baseline interim diagnoses were not reported for the MLP and PLCO trial.…”

Section: Elcap To New York Elcap To International Elcapmentioning

confidence: 99%

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CT Screening for Lung Cancer: Update 2007

Henschke

Yankelevitz

2008

The Oncologist

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Screening is the pursuit of the early diagnosis of cancer before symptoms occur. The purpose of early diagnosis is to provide early treatment, which potentially prevents death from the cancer. The usefulness of screening depends on how early the cancer can be diagnosed and how many deaths can be prevented by early treatment as compared with later symptom-prompted diagnosis and treatment.The goal of the Early Lung Cancer Action Project investigators was to develop an efficient methodology that would provide an ever-accumulating, continually updated body of evidence for evaluation of emerging new technologies for screening for cancer. This methodology recognizes that screening is a sequential process that starts with the pursuit of the early diagnosis of cancer followed by early treatment. It also recognizes that diagnostic research is fundamentally different from treatment research. To fully understand the current discussions on the evidence for lung cancer screening, key definitions are provided, including the differentiation between the first, baseline round of screening and all subsequent rounds of repeat screening and baseline and repeat cancers and their distribution by cell type. These definitions are critical in analyzing the results of various screening reports as they are not used by all.To provide optimal screening, a regimen for the diagnostic workup must be specified starting with the definition of the initial test, its positive result, and the workup for a positive result leading to a diagnosis of cancer. Assessment of diagnostic performance does not require a control group, but does require confirmation of the diagnosis.For assessment of the effectiveness of early treatment, a comparison group is needed. The comparison group may be formed by randomly assigning people with screen-diagnosed lung cancer to immediate or delayed treatment, as has been done for prostate cancer. This provides a direct assessment of any potential overdiagnosis of the cancer resulting from screening. Alternatively, a quasiexperimental control group can be used KEY CONCEPTS AND DEFINITIONSScreening has been defined as the pursuit of the early diagnosis of cancer before symptoms occur. The purpose of early diagnosis is to provide early treatment, which potentially prevents death from the cancer. The usefulness of screening depends on how early the cancer can be diagnosed and how many deaths can be prevented by early treatment as compared with later symptom-prompted diagnosis and treatment. To fully understand current discussions on the evidence for lung cancer screening, key concepts of screening and definitions are needed.Screening for a cancer should be considered when the cancer is significant in terms of incidence and mortality, treatment of early-stage disease is better than treatment of late-stage disease, and there is a test that provides an earlier diagnosis-lead time-rather than a later, symptomprompted diagnosis [1,2].Lung cancer kills more people than any other cancer worldwide. In the U.S. it kills more pe...

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supporting

confidence: 84%

Section: Advantages Of the Elcap Approachmentioning

confidence: 99%

Section: Elcap To New York Elcap To International Elcapmentioning

confidence: 99%

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CT Screening for Lung Cancer: Update 2007

Henschke

Yankelevitz

2008

The Oncologist

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“…There was no significant difference in the incidence of cancer between the screening and control groups. [16] In the analysis made in the following years, both groups were compared in terms of mortality; however, but there was no significant difference between them. [17] In the Early Lung Cancer Action Project (ELCAP) that was performed by Henschke et al in the USA, 1.000 people aged more than 60 years who had a history of more than 10 pack years of smoking were included.…”

Section: Discussionmentioning

confidence: 99%

A Cross-sectional Study in Konya; 2,015 Evaluation of Lung Graph

Alkan

Tolu

İnal³

et al. 2017

EJMO

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E pidemiological studies, which are defined as the examination of the incidence of diseases in society and the factors affecting it, are aimed to reveal the incidence and causes of the disease, to eliminate the disease agents, and to manage the resources efficiently and correctly. [1] Posteroanterior (PA) chest radiograph, one of the earliest practical methods used to detect thoracic pathologies, is used in imaging the trachea, mediastinum, the heart, the diaphragm, subdiaphragmatic areas, hilus, pulmonary vasculature, fissures, sinuses, lung parenchyma, pleura, soft Objectives: This study was an evaluation of posteroanterior chest radiographs taken of residents of Konya determined by the cluster sampling method. Methods: This study was a descriptive cross-sectional study, conducted in cooperation with the Konya Education and Research Hospital, the provincial health directorate, and the metropolitan municipality. The sociodemographic characteristics of 2015 individuals participating in the study were recorded. The standard chest radiographs, which were taken with a traditional analog system during inspiration in the standing position, were evaluated by 2 radiologists. The most obvious pathological finding was recorded. Results: Of the participants, 1075 (53.40%) were female and 940 (46.60%) were male. The mean age was 45.89±0.45 years for the women and 46.20±0.54 years for the men. In the group, 340 (16.90%) were retired, 492 (24.40%) were farmers and/or laborers, 144 (7.10%) were white-collar employees, and 1039 (51.60%) were housewives or unemployed. In all, 580 (28.80%) were cigarette smokers. While 249 (12.36%) had pathological findings on the chest radiograph, 1766 (87.64%) had normal results. The pathological findings were hilar fullness (n=50, 2.48%), emphysematous appearance (n=48, 2.38%), nodule (n=29, 1.44%), increased reticulonodular density (n=26, 1.29%), increased bronchovascular branching (n=9, 0.44%), bronchiectasis (n=4, 0.20%), and other changes (n=83, 4.12%). The incidence of emphysematous appearance was 2.77 times greater in the smokers than in the non-smokers (p<0.05; odds ratio [OR]: 2.77, confidence interval [CI]: 1.56-4.91). While the chest X-ray was normal in 93.50% of the individuals under the age of 40 years, the rate decreased to 84.60% in the individuals over the age of 40 years. The incidence of a pathological chest radiograph was also 2.62 times higher in individuals over the age of 40 years (p<0.001; OR: 2.62, CI:1.90-3.61). Conclusion:The incidence of pathological lung findings was greater in individuals over the age of 40 years, and in workers and retirees.

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“…Current and former smokers were the major portion of the participants diagnosed with lung cancer. 16 After 13 years follow up, cumulative lung cancer incidence rate was 20.1 per 10.000 person-years in the intervention group and 19.2 per 10.000 person-years in the usual care group (RR: 1.05; 95% CI: 0.98-1.12). After total 13 years follow up period, 1.213 participants died from lung cancer in the intervention group and 1.230 in the usual care group.…”

mentioning

confidence: 94%

Lung Cancer Screening: A Comprehensive Review of the Literature with Detailed Data

Açıkgöz¹,

Şendur²,

Özdemir³

et al. 2014

UHOD

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Lung cancer still has a big proportion of cancer related deaths inspite of improvements in chemotherapeutic and surgical treatment approaches. It has a strong relationship with tobacco comsumption so that it can be regard as a common health problem. The survival rates of lung cancer at earlier stages are higher than later stages, so it is worth to effort detect lung cancer at an early stages which can cause mortality reduction and survival improvement. Some screening methods were used in screening trials to achieve a satisfactory mortality reduction with increased survival rates. We discussed about the results of important big trials which have different methods and qualities. There are two important screening tools to discuss about including; chest x-ray and low dose computed thomography (CT). Although there were many randomized or non-randomized trials used these tools for screening programs, few studies have enough power and quality to interpret the results. In this review, we discuss about the latest and detailed data of screening trials including, The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, Mayo Lung Project, The National Lung Screning Trial (NLST), The NELSON trial, The International Early Lung Cancer Action Program (I-ELCAP). Among the results of the trials we discussed about, only screening with low dose CT showed a statistically significant reduction of lung cancer deaths with increased early detection in high risk patients. Of these trials, the NLST which showed 20% mortality reduction in lung cancer and 6.7% mortality reduction from any cause has enough power to achieve this target and this results have affected nearly all of guidelines and recommendations of experts. The results of studies with low dose CT, especially of the NLST, changed thoughts about lung cancer screening. According to these results, the high risk individuals are suggested to be screened with low dose CT by almost experts and societies. In contrast, there should be further evaluations to clarify costs, harm effects of screening with low dose CT programs or related consequence procedures. Smoke cessation is still the most important strategy for reducing the burden of lung cancer, despite the promising results of screening trials.Keywords: Lung cancer, Cancer, Screening, Chest x-ray, Low dose CT, Methods ÖZET Akciğer Kanseri Taraması; Literatürün Güncel Veriler Eşliğinde Detaylı İncelenmesiAkciğer kanseri kemoterapötik ve cerrahi tedavilerdeki gelişmelere rağmen hala kanserle ilişkili ölümlerin büyük bir kısmını oluşturmaktadır. Akciğer kanseri sigara tüketimi ile olan sıkı birlikteliği sebebiyle bir halk sağlığı problemi olarak görülebilir. Erken evrelerde akciğer kanserinin sağ kalım oranı ileri evrelerden daha yüksektir, bu nedenle mortalite oranını azaltabilecek ve sağ kalım oranını da arttırabilecek olan erken evrelerde akciğer kanserini teşhis etmeye dönük çabalar gerekmektedir. Mortalitede tatmin edici bir azalma ile beraber sağ kalımı artırmayı hedefleyen çalışmalarda bazı tarama metodla...

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Baseline Chest Radiograph for Lung Cancer Detection in the Randomized Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Abstract: In the baseline screen, nearly half the cancers were stage I. Whether this experience results in a reduction in lung cancer mortality is yet to be seen.

Cited by 105 publications

References 25 publications

CT Screening for Lung Cancer: Update 2007

CT Screening for Lung Cancer: Update 2007

A Cross-sectional Study in Konya; 2,015 Evaluation of Lung Graph

Lung Cancer Screening: A Comprehensive Review of the Literature with Detailed Data

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