Diagnostic Performance of Low-Dose Computed Tomography Screening for Lung Cancer over Five Years

摘要: Introduction: Low-dose computed tomography (LD-CT) screening can reduce lung cancer mortality; however, it is essential to improve nodule management protocols. We analyze the performance of diagnostic protocol Continuous Observation SMOking Subjects single-center study, after long-term follow-up. Methods: Between 2004 and 2005, 5203 asymptomatic high-risk individuals (≥20 pack-years, aged 50 years or older) were enrolled undergo annual LD-CT for 5 years. Nodules mm smaller underwent repeat a year later. larger than 5.0 8.0 received 3 6 months growing CT-positron emission tomography. True positives any stage prevalent cancer, progressing nodules diagnosed at 1, localized multifocal new stage. False negatives >1. benign resected surgically. Results: Compliance was 79% over years; 175 primary cancers detected (0.76% per year), 136 (77.7%) N0M0 three interval cancers. Eleven second diagnosed. Resectability 87.4%; postoperative mortality 0.6%. Recall 6.4% overall, 10.1% baseline. 14 (8%). Protocol sensitivity 158 (90%); specificity 4994 5028 (99.4%); positive predictive value 187 (84.5%); negative 5016 (99.7%). Twenty-nine 204 (14.2%) lesions Five-year overall cancer-specific survival 78% (95% confidence interval, 72–84) 82% 76%–88%) respectively. Conclusions: The CT satisfactory with an acceptable number biopsied surgically, low recall rate, good oncological outcomes. However, advanced cancers, misdiagnoses, need be reduced, perhaps by risk modeling use serum markers.