Abstract
Rationale: Screening for lung cancer with modern imaging technology may decrease lung cancer mortality, but encouraging results have only been obtained in uncontrolled studies. Objectives: To explore the effect of screening with low-dose spiral computed tomography (LDCT) on lung cancer mortality. Secondary endpoints are incidence, stage at diagnosis, and resectability. Methods: Male subjects, aged 60 to 75 years, smokers of 20 or more pack-years, were randomized to screening with LDCT or control groups. All participants underwent a baseline, once-only chest X-ray and sputum cytology examination. Screening-arm subjects had LDCT upon accrual to be repeated every year for 4 years, whereas controls had a yearly medical examination only. Measurements and Main Results: A total of 2,811 subjects were randomized and 2,472 were enrolled (LDCT, 1,276; control, 1,196). After a median follow-up of 33 months, lung cancer was detected in 60 (4.7%) patients receiving LDCT and 34 (2.8%) control subjects (P = 0.016). Resectability rates were similar in both groups. More patients with stage I disease were detected by LDCT (54 vs. 34%; P = 0.06) and fewer cases were detected in the screening arm due to intercurrent symptoms. However, the number of advanced lung cancer cases was the same as in the control arm. Twenty patients in the LDCT group (1.6%) and 20 controls (1.7%) died of lung cancer, whereas 26 and 25 died of other causes, respectively. Conclusions: The mortality benefit from lung cancer screening by LDCT might be far smaller than anticipated.
| Original language | English |
|---|---|
| Pages (from-to) | 445-453 |
| Number of pages | 9 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 180 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sep 1 2009 |
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Keywords
- Early diagnosis
- Lung neoplasms
- Randomized controlled trial
- Screening
- Spiral computed tomography
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
Cite this
A randomized study of lung cancer screening with spiral computed tomography : Three-year results from the DANTE trial. / Infante, Maurizio; Cavuto, Silvio; Lutman, Fabio Romano; Brambilla, Giorgio; Chiesa, Giuseppe; Ceresoli, Giovanni; Passera, Eliseo; Angeli, Enzo; Chiarenza, Maurizio; Aranzulla, Giuseppe; Cariboni, Umberto; Errico, Valentina; Inzirillo, Francesco; Bottoni, Edoardo; Voulaz, Emanuele; Alloisio, Marco; Destro, Anna; Roncalli, Massimo; Santoro, Armando; Ravasi, Gianluigi.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 180, No. 5, 01.09.2009, p. 445-453.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A randomized study of lung cancer screening with spiral computed tomography
T2 - Three-year results from the DANTE trial
AU - Infante, Maurizio
AU - Cavuto, Silvio
AU - Lutman, Fabio Romano
AU - Brambilla, Giorgio
AU - Chiesa, Giuseppe
AU - Ceresoli, Giovanni
AU - Passera, Eliseo
AU - Angeli, Enzo
AU - Chiarenza, Maurizio
AU - Aranzulla, Giuseppe
AU - Cariboni, Umberto
AU - Errico, Valentina
AU - Inzirillo, Francesco
AU - Bottoni, Edoardo
AU - Voulaz, Emanuele
AU - Alloisio, Marco
AU - Destro, Anna
AU - Roncalli, Massimo
AU - Santoro, Armando
AU - Ravasi, Gianluigi
PY - 2009/9/1
Y1 - 2009/9/1
N2 - Rationale: Screening for lung cancer with modern imaging technology may decrease lung cancer mortality, but encouraging results have only been obtained in uncontrolled studies. Objectives: To explore the effect of screening with low-dose spiral computed tomography (LDCT) on lung cancer mortality. Secondary endpoints are incidence, stage at diagnosis, and resectability. Methods: Male subjects, aged 60 to 75 years, smokers of 20 or more pack-years, were randomized to screening with LDCT or control groups. All participants underwent a baseline, once-only chest X-ray and sputum cytology examination. Screening-arm subjects had LDCT upon accrual to be repeated every year for 4 years, whereas controls had a yearly medical examination only. Measurements and Main Results: A total of 2,811 subjects were randomized and 2,472 were enrolled (LDCT, 1,276; control, 1,196). After a median follow-up of 33 months, lung cancer was detected in 60 (4.7%) patients receiving LDCT and 34 (2.8%) control subjects (P = 0.016). Resectability rates were similar in both groups. More patients with stage I disease were detected by LDCT (54 vs. 34%; P = 0.06) and fewer cases were detected in the screening arm due to intercurrent symptoms. However, the number of advanced lung cancer cases was the same as in the control arm. Twenty patients in the LDCT group (1.6%) and 20 controls (1.7%) died of lung cancer, whereas 26 and 25 died of other causes, respectively. Conclusions: The mortality benefit from lung cancer screening by LDCT might be far smaller than anticipated.
AB - Rationale: Screening for lung cancer with modern imaging technology may decrease lung cancer mortality, but encouraging results have only been obtained in uncontrolled studies. Objectives: To explore the effect of screening with low-dose spiral computed tomography (LDCT) on lung cancer mortality. Secondary endpoints are incidence, stage at diagnosis, and resectability. Methods: Male subjects, aged 60 to 75 years, smokers of 20 or more pack-years, were randomized to screening with LDCT or control groups. All participants underwent a baseline, once-only chest X-ray and sputum cytology examination. Screening-arm subjects had LDCT upon accrual to be repeated every year for 4 years, whereas controls had a yearly medical examination only. Measurements and Main Results: A total of 2,811 subjects were randomized and 2,472 were enrolled (LDCT, 1,276; control, 1,196). After a median follow-up of 33 months, lung cancer was detected in 60 (4.7%) patients receiving LDCT and 34 (2.8%) control subjects (P = 0.016). Resectability rates were similar in both groups. More patients with stage I disease were detected by LDCT (54 vs. 34%; P = 0.06) and fewer cases were detected in the screening arm due to intercurrent symptoms. However, the number of advanced lung cancer cases was the same as in the control arm. Twenty patients in the LDCT group (1.6%) and 20 controls (1.7%) died of lung cancer, whereas 26 and 25 died of other causes, respectively. Conclusions: The mortality benefit from lung cancer screening by LDCT might be far smaller than anticipated.
KW - Early diagnosis
KW - Lung neoplasms
KW - Randomized controlled trial
KW - Screening
KW - Spiral computed tomography
UR - http://www.scopus.com/inward/record.url?scp=69249108174&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=69249108174&partnerID=8YFLogxK
U2 - 10.1164/rccm.200901-0076OC
DO - 10.1164/rccm.200901-0076OC
M3 - Article
C2 - 19520905
AN - SCOPUS:69249108174
VL - 180
SP - 445
EP - 453
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 5
ER -