• Takeshi Nawa, Tohru Nakagawa, Tetsuya Mizoue, Suzushi Kusano, Tatsuya Chonan, Shimao Fukai, and Katsuyuki Endo.
• Department of Internal Medicine, Hitachi General Hospital, 2-1-1, Jonan, Hitachi City, Ibaraki 317-0077, Japan. takeshi.nawa.nw@hitachi.com
• Lung Cancer. 2012 Feb 1; 75 (2): 197-202.

AbstractThe effectiveness of lung cancer screening using low-dose chest computed tomography (CT) remains elusive. The present study examined the prognosis of patients with lung cancer detected on CT screening in Japanese men and women. Subjects were 210 patients with primary lung cancer identified on CT screening at two medical facilities in Hitachi, Japan, where a total of 61,914 CT screenings were performed among 25,385 screenees between 1998 and 2006. Prognostic status of these patients was sought by examining medical records at local hospitals, supplemented by vital status information from local government. The 5-year survival rate was estimated according to the characteristics of patients and lung nodule. A total of 203 (97%) patients underwent surgery. During a 5.7-year mean follow-up period, 19 patients died from lung cancer and 6 died from other causes. The estimated 5-year survival rate for all patients and for those on stage IA was 90% and 97%, respectively. Besides cancer stage, smoking and nodule appearance were independent predictors of a poor survival; multivariable-adjusted hazard ratio (95% confidence interval) was 4.7 (1.3, 16.5) for current and past smokers versus nonsmokers and 4.6 (1.6, 13.9) for solid nodule versus others. Even patients with solid shadow had a 5-year survival of 82% if the lesion was 20mm or less in size. Results suggest that lung cancers detected on CT screening are mostly curative. The impact of CT screening on mortality at community level needs to be clarified by monitoring lung cancer deaths.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

16 keywords...

hide…