Three-year findings of an early lung cancer detection feasibility study with low-dose spiral computed tomography in heavy smokers

Abstract

Despite some promising data, convincing evidence from ongoing randomized trials is needed to support the routine use of sCT as a recommended tool for screening of lung cancer.

Nodulo polmonare: caratteristiche clinico-radiologiche che possono influenzare la diagnosi di malignità

“…New-generation CT scanners are able to detect increasingly small SPNs and the numerous lung-cancer screening programmes using low-dose CT throughout the world require the development of effective diagnostic and therapeutic protocols for managing SPNs. Data from one of the main low-dose CT screening programmes, in the United States, showed that none of the detected malignancies was <5 mm [70], and similar results were obtained in an analogous 5-year research project conducted at our institute [71]. These data, which await validation by studies that are still Approccio al nodulo polmonare: l'opinione dello pneumo-oncologo Il management del NPS è un argomento assai dibattuto e tuttora non completamente definito in quanto le nuove apparecchiature TC consentono di riconoscere NPS di dimensioni sempre più piccole ed i numerosi programmi di screening con TC a bassa dose, applicati ormai in tutto il mondo, richiedono lo sviluppo di percorsi diagnostico-terapeutici efficaci per la gestione del NPS.…”

“…These data, which await validation by studies that are still Approccio al nodulo polmonare: l'opinione dello pneumo-oncologo Il management del NPS è un argomento assai dibattuto e tuttora non completamente definito in quanto le nuove apparecchiature TC consentono di riconoscere NPS di dimensioni sempre più piccole ed i numerosi programmi di screening con TC a bassa dose, applicati ormai in tutto il mondo, richiedono lo sviluppo di percorsi diagnostico-terapeutici efficaci per la gestione del NPS. Da uno dei principali programmi di screening con TC a bassa dose, condotto negli Stati Uniti, è emerso che nessuna delle lesioni maligne diagnosticate presentava dimensioni inferiori a 5 mm [70] e risultati sovrapponibili sono stati conseguiti al termine di 5 anni di un lavoro di ricerca analogo, condotto nel nostro istituto [71]. Questi dati, che peraltro andranno consolidati e supportati da studi ancora in corso, suggeriscono l'improbabilità che un NPS di dimensioni inferiori a 5 mm possa essere maligno: al momento vanno quindi considerati inadeguati l'atteggiamento aggressivo o ricontrolli troppo ravvicinati.…”

Early Lung Cancer Detection Using the Self-Evaluation Scoring Questionnaire and Chest Digital Radiography: A 3-Year Follow-up Study in China

“…However, the criteria for determining high-risk groups have not yet been unified. Generally speaking, active cigarette consumption is the well-known principal respondent, so nearly all of the present studies focused on heavy smokers and the results were desirable [7,17,18,28]. With the progress of research, passive smoking and exposure to cooking fumes have attracted more and more attention [19,20].…”

“…Generally speaking, typical noncalcified nodules refer to solid lesions with diameters ranging from 8 to 30 mm [26,27]. Malignant probability for the smaller ones are usually low, especially for those less than 5 mm, only about 0-1 % [27][28][29]. Accordingly, we overlooked nodules with a maximum diameter below 5 mm; but larger ones over 30 mm were considered to be positive.…”

The Future in Diagnosis and Staging of Lung Cancer: Introduction

“…The use of low-dose spiral computed tomography (CT) in lung cancer screening and the use of new molecular markers has brought realistic hope that these novel approaches may do better that the historical experience with chest X-ray and simple sputum cytology [1] . The fi rst contribution to this series by Pastorino et al will focus on the current knowledge of lung cancer screening and the need for validation of this concept in randomized controlled trials.…”