TY  - CHAP
M1  - Book, Section
TI  - Screening for Lung Cancer
A1  - Fitzpatrick, Meghan E.
A1  - Prendergast, Niall T.
A1  - Rivera-Lebron, Belinda
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
Y1  - 2022
N1  - 
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Lung  cancer  remains  the  leading  cause  of  cancer-related  mortality,  in  large  part  secondary  to  advanced  stage  at  diagnosis  (Chapter  39).  Two  large  RCTs  reported  findings  in  2011  regarding  the  utility  of  lung  cancer  screening.  The  Prostate,  Lung,  Colorectal  and  Ovarian  Randomized  Trial  (PLCO)  randomized  154,901  adults  (52%  current  or  former  smokers)  between  the  ages  of  55  and  74  years  to  receive  either  no  screening  or  annual  posterior-anterior  chest  radiographs  for  4  consecutive  years.  The  investigators  monitored  the  participants  after  screening  for  an  average  of  12  years.  Results  showed  no  mortality  benefit  from  four  annual  chest  radiographs  either  in  the  whole  cohort  or  in  a  subset  of  heavy  smokers  who  met  the  entry  criteria  for  the  other  major  trial,  the  National  Lung  Screening  Trial  (NLST).  The  NLST  enrolled  53,454  current  or  former  smokers  (minimum  30-pack  year  exposure  history)  between  the  ages  of  55  and  74  years  who  were  randomly  assigned  to  one  of  two  screening  modalities:  three  annual  posterior-anterior  chest  radiographs  or  three  annual  low-dose  chest  CT  scans.  They  were  monitored  for  an  additional  6.5  years  after  screening.  Compared  with  chest  radiography,  low-dose  chest  CT  detected  more  early-stage  lung  cancers  and  fewer  advanced-stage  lung  cancers,  indicating  that  CT  screening  systematically  shifted  the  time  of  diagnosis  to  earlier  stages,  thereby  providing  more  persons  the  opportunity  for  effective  treatment.  Furthermore,  compared  with  chest  radiographs,  the  cohort  that  received  three  annual  CT  scans  had  a  statistically  significant  mortality  benefit,  with  reductions  in  both  lung  cancer  deaths  (20.0%)  and  all-cause  mortality  (6.7%).  This  was  the  first  evidence  from  an  RCT  demonstrating  that  lung  cancer  screening  reduced  all-cause  mortality.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1186012854
ER  -