P-270 Lung cancer screening using low-dose computed tomography:The Toronto experience

Roberts, Hazel; Patsios, Demetris; Paul, Narinder; Chung, Ta Jung; Boerner, Scott; Waddell, Louis C.; Keshavjee, Shaf; Darling, Gail; Tsao, Ming‐Sound; Shepherd, F.

doi:10.1016/s0169-5002(05)80764-0

Cited by 9 publications

(11 citation statements)

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“…In the International Early Lung Cancer Action Project (I-ELCAP) screening study, LDCT detected almost six-times as many stage I lung cancers as chest radiography and most of these tumours were no larger than 1 cm in diameter [148]. Numerous other publications resulted from the study demonstrating prolonged survival in the CT screened group with no difference in mortality [149][150][151][152]. Some authors, however, pointed out that the results should be interpreted cautiously because the study reported by the I-ELCAP [149] had no control group, lacked an unbiased outcome measure, did not consider what was already known about this topic from previous studies and did not address the harms of screening [153].…”

Section: Lung Cancer Screeningmentioning

confidence: 99%

Exhaled biomarkers in lung cancer

Horváth

Lázár

Gyulai

et al. 2009

European Respiratory Journal

239

206

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Lung cancer is the leading cause of cancer death. Results of therapeutic interventions are particularly discouraging when the disease is discovered in an advanced stage. Early diagnosis is limited by the fact that the disease usually develops asymptomatically and available screening methods do not fulfil the requirements for reliable discrimination between patients with lung cancer and subjects not suffering from the disease. Breath sampling is completely noninvasive and provides a potentially useful approach to screening lung cancer. Exhaled biomarkers contain both volatile and nonvolatile molecules. The profile of volatile organic compounds is different in patients with lung cancer than in control subjects. In exhaled breath condensate, the proteomic profile of breath from cancer patients differs from that of healthy smokers. We reviewed the scientific evidence demonstrating that a unique chemical signature can be detected in the breath of patients with lung cancer and that the exhaled breath biomarker profile could aid clinical decision making.KEYWORDS: Biomarker, electronic nose, exhaled breath, exhaled breath condensate, lung cancer, smell L ung cancer is the leading cause of global cancer death in both males and females. According to the most recent projection of global mortality, by 2030 it will emerge as the third and the fifth leading cause of death in highand middle-income countries, respectively [1,2]. Figures on disease outcome measures are very discouraging as even with the most advanced treatment strategies ,86% of lung cancer patients die within 5 yrs of diagnosis. With early detection and treatment, however, the 5-yr survival rate improves dramatically from 20% in patients with stage III lung cancer to 70% in patients with stage I disease [3]. Researchers, therefore, have sought out screening tests to detect lung cancer in the earliest stages and several promising new approaches have been proposed for this purpose, such as computer-assisted image analysis of chest radiographs, spiral computed tomography (CT) scanning, PCR-based assays of sputum and fluorescence bronchoscopy [4][5][6][7].Breath chemical tests have a broad spectrum of applications ranging from the US Food and Drug Administration-approved exhaled nitric oxide fraction (FeNO) measurement to monitor the effect of anti-inflammatory treatment in asthma, to volatile organic compound (VOC) determination and nonvolatile biomarker profiling in the cooled breath sample called exhaled breath condensate (EBC) [8][9][10][11]. Being completely noninvasive, sampling of the breath allows clinicians and researchers to assess different body functions in a flexible manner. Breath collection can be performed even in very severe patients and also repeated within short intervals. Therefore, breath testing is considered to be a potentially ideal candidate for screening purposes. Besides widely known constituents such as nitrogen, oxygen, carbon dioxide, inert gases and water vapour, exhaled breath also consists of thousands of volatile and nonv...

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Section: Lung Cancer Screeningmentioning

confidence: 99%

Exhaled biomarkers in lung cancer

Horváth

Lázár

Gyulai

et al. 2009

European Respiratory Journal

239

206

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“…Recent technological advances with the introduction of the spiral technique and MDCT scanners have greatly improved anatomical detail and sensitivity of this modality, which is now capable of detecting even nodules as small as 1-2 mm [7]. This situation has, however, raised significant diagnostic dilemmas over the correct management of these frequent findings, which are detected in 43%-76% of patients depending on the case series [8,9]. Statistically, most nodules <10 mm turn out to be benign (for nodules above and below that dimensional threshold, the malignancy rates are 5% and 50%, respectively) [10], 406 Radiol med (2010) Per quanto concerne il confronto tra i volumi calcolati con i diversi algoritmi di segmentazione della versione 2007S, i volumi ottenuti con la modalità AllSizeNodule sono risultati essere mediamente superiori del 71,08% (range 6,8%-218,8%) rispetto a quelli calcolati con la modalità SmallSizeNodule.…”

Section: Discussionmentioning

confidence: 99%

“…Il progresso tecnologico degli ultimi anni, con l'introduzione della tecnica spirale e delle TC multidetettore, ha notevolmente migliorato il dettaglio anatomico e la sensibilità della metodica consentendole di identificare anche noduli dell'ordine dei 1-2 mm [7]. Tutto ciò ha però aperto importanti dilemmi diagnostici circa la corretta gestione di tali reperti che risultano di riscontro assai frequente, con incidenze variabili dal 43% al 76% dei pazienti a seconda delle casistiche [8,9]. Statisticamente la maggior parte dei noduli inferiori ad 10 mm risulta essere di natura benigna (sopra e sotto questa soglia dimensionale i tassi di malignità sono rispettivamente del 5% e del 50%) [10], ma non sono sempre presenti univoci elementi semeiologici in grado di distinguere con accuratezza i noduli although unequivocal signs allowing accurate differentiation between benign nodules and early malignancies are not always available.…”

Section: Discussioneunclassified

Three-dimensional analysis of pulmonary nodules: variability of semiautomated volume measurements between different versions of the same software

et al. 2010

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“…& The Canadian I-ELCAP site reported 1000 baseline screens in high-risk individuals. They identified 20 lung cancers, 19 of which were non-small cell carcinomas, and 15 were stage I [3]. & The Cosmos trial reported baseline screening results from 5201 high-risk subjects and an annual screen from 4815.…”

Section: Evidence Basementioning

confidence: 99%

Lung Cancer Screening: An Update, Discussion, and Look Ahead

Mazzone

2010

Curr Oncol Rep

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Over the past few years there has been a great deal of debate about the status of lung cancer screening. The debate has focused on at least three areas: the unmet need to prove a mortality reduction from the screening tests being studied, the potential for these screening tests to produce harm, and the possible cost-effectiveness of an image-based screening program. In this manuscript, I review the chest imaging cohort and controlled trials that have been added to the evidence base over the past few years. I then discuss the evidence related to the areas that are currently debated, describe the ongoing trials that will help to clarify these issues, and speculate about the future.

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P-270 Lung cancer screening using low-dose computed tomography:The Toronto experience

Cited by 9 publications

References 0 publications

Exhaled biomarkers in lung cancer

Exhaled biomarkers in lung cancer

Three-dimensional analysis of pulmonary nodules: variability of semiautomated volume measurements between different versions of the same software

Lung Cancer Screening: An Update, Discussion, and Look Ahead

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