Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results.

摘要: Summary Background Low-dose spiral CT of the chest effectively detects early-stage lung cancer in high-risk individuals. The high rate benign nodules and issues making a differential diagnosis are critical factors that currently hamper introduction large-scale screening programmes. We investigated efficacy repeated yearly selective use positron emission tomography (PET) large cohort volunteers. Methods enrolled 1035 individuals aged 50 years or older who had smoked for 20 pack-years more. All patients underwent annual low-dose CT, with without PET, 5 years. Lesions up to mm were deemed non-suspicious was after 12 months (year 2). Findings By year 2, 22 cases been diagnosed (11 at baseline, 11 440 lesions identified 298 (29%) participants, 95 recalled high-resolution contrast CT. PET scans positive 18 indentified cases. Six surgical biopsy disease because false-positive results (6% recalls, 22% invasive procedures). Complete resection achieved 21 (95%) cancers, 17 (77%) pathological stage I (100% 2), mean tumour size mm. There no interval cancers 2·5 follow (average time on study from randomisation last contact), although 19 another form (two deaths non-fatal admissions). Interpretation Combined early cancer. can be checked again major risks progression.