Tobacco.org

Survival of Patients with Stage I Lung Cancer Detected on CT Screening 

Are these results sufficiently effective to justify screening people who are at risk of lung cancer? As compared with mammographic screening for breast cancer, for lung cancer the rates of detection among the participants in this study who were 40 years of age and older were 1.3% on baseline CT screening and 0.3% on annual screening (Table 2), values that were slightly higher than those for the detection of breast cancer (0.6 to 1.0% on baseline screening) and similar to those for annual screening (0.2 to 0.4%) among women 40 years of age and older.22 The rate of cancer detection depends on the risk profile of those undergoing screening; the higher the risk, the more productive the screening. Thus, as expected, CT screening of the original participants in ELCAP, who were former and current smokers 60 years of age and older,1,2 was more productive in detecting lung cancer (detection rates, 2.7% on baseline screening and 0.6% on annual screening) than among participants in the expanded study. The cost of low-dose CT is below $200,23,24,25,26 and surgery for stage I lung cancer is less than half the cost of late-stage treatment.26,27 Using the original ELCAP data and the actual hospital costs for the workup, we found CT screening for lung cancer to be highly cost-effective.23 Other estimates of the cost-effectiveness of CT screening for lung cancer for various risk profiles24,25,26,28 are similar to that for mammography screening.29,30

Supported in part by the National Institutes of Health (grants R01-CA-633931, to Dr. Henschke, and R01-CA-78905, to Dr. Yankelevitz); the Department of Energy (DE-FG02-96SF21260, to Dr. Markowitz); the Department of Defense to Dr. Tockman; Department of Health and Mental Hygiene of the City of New York; New York State Office of Science, Technology, and Academic Research; American Cancer Society; Israel Cancer Association; Starr Foundation; New York Community Trust; Rogers Family Fund; Foundation for Lung Cancer: Early Detection, Prevention, and Treatment; Foundation for Early Detection of Lung Cancer; Dorothy R. Cohen Foundation; Research Foundation of Clinic Hirslanden; Clinic Hirslanden; Swedish Hospital; Yad-Hanadiv Foundation; Jacob and Malka Goldfarb Charitable Foundation; Auen–Berger Foundation; Princess Margaret Foundation; Tenet Healthcare Foundation; Ernest E. Stempel Foundation, Academic Medical Development; Empire Blue Cross and Blue Shield; Eastman Kodak; General Electric; Weill Medical College of Cornell University; New York Presbyterian Hospital; Christiana Care Helen F. Graham Cancer Center; Holy Cross Hospital; Eisenhower Hospital; Jackson Memorial Hospital Health System; and Evanston Northwestern Healthcare.

Jump to full article »