Abstract
RATIONALE: Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting.
OBJECTIVES: To explore the effect of LDCT screening on lung cancer mortality compared with no screening. Secondary endpoints included incidence, stage, and resectability rates.
METHODS: Male smokers of 20+ pack-years, aged 60 to 74 years, underwent a baseline CXR and sputum cytology examination and received five screening rounds with LDCT or a yearly clinical review only in a randomized fashion.
MEASUREMENTS AND MAIN RESULTS: A total of 1,264 subjects were enrolled in the LDCT arm and 1,186 in the control arm. Their median age was 64.0 years (interquartile range, 5), and median smoking exposure was 45.0 pack-years. The median follow-up was 8.35 years. One hundred four patients (8.23%) were diagnosed with lung cancer in the screening arm (66 by CT), 47 of whom (3.71%) had stage I disease; 72 control patients (6.07%) were diagnosed with lung cancer, with 16 (1.35%) being stage I cases. Lung cancer mortality was 543 per 100,000 person-years (95% confidence interval, 413-700) in the LDCT arm versus 544 per 100,000 person-years (95% CI, 410-709) in the control arm (hazard ratio, 0.993; 95% confidence interval, 0.688-1.433).
CONCLUSIONS: Because of its limited statistical power, the results of the DANTE (Detection And screening of early lung cancer with Novel imaging TEchnology) trial do not allow us to make a definitive statement about the efficacy of LDCT screening. However, they underline the importance of obtaining additional data from randomized trials with intervention-free reference arms before the implementation of population screening.
| Original language | English |
|---|---|
| Pages (from-to) | 1166-1175 |
| Number of pages | 10 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 191 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - May 15 2015 |
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Keywords
- early diagnosis
- lung neoplasms
- randomized controlled trial
- screening
- spiral computed tomography
ASJC Scopus subject areas
- Medicine(all)
Cite this
Long-Term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography. / Infante, Maurizio; Cavuto, Silvio; Lutman, Fabio R omano; Passera, Eliseo; Chiarenza, Maurizio; Chiesa, Giuseppe; Brambilla, Giorgio; Angeli, Enzo; Aranzulla, Giuseppe; Chiti, Arturo; Scorsetti, Marta; Navarria, Pierina; Cavina, Raffaele; Ciccarelli, Michele; Roncalli, Massimo; Destro, Anna; Bottoni, Edoardo; Voulaz, Emanuele; Errico, Valentina; Ferraroli, Giorgio; Finocchiaro, Giovanna; Toschi, Luca; Santoro, Armando; Alloisio, Marco; DANTE Study Group.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 191, No. 10, 15.05.2015, p. 1166-1175.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-Term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography
AU - Infante, Maurizio
AU - Cavuto, Silvio
AU - Lutman, Fabio R omano
AU - Passera, Eliseo
AU - Chiarenza, Maurizio
AU - Chiesa, Giuseppe
AU - Brambilla, Giorgio
AU - Angeli, Enzo
AU - Aranzulla, Giuseppe
AU - Chiti, Arturo
AU - Scorsetti, Marta
AU - Navarria, Pierina
AU - Cavina, Raffaele
AU - Ciccarelli, Michele
AU - Roncalli, Massimo
AU - Destro, Anna
AU - Bottoni, Edoardo
AU - Voulaz, Emanuele
AU - Errico, Valentina
AU - Ferraroli, Giorgio
AU - Finocchiaro, Giovanna
AU - Toschi, Luca
AU - Santoro, Armando
AU - Alloisio, Marco
AU - DANTE Study Group
PY - 2015/5/15
Y1 - 2015/5/15
N2 - RATIONALE: Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting.OBJECTIVES: To explore the effect of LDCT screening on lung cancer mortality compared with no screening. Secondary endpoints included incidence, stage, and resectability rates.METHODS: Male smokers of 20+ pack-years, aged 60 to 74 years, underwent a baseline CXR and sputum cytology examination and received five screening rounds with LDCT or a yearly clinical review only in a randomized fashion.MEASUREMENTS AND MAIN RESULTS: A total of 1,264 subjects were enrolled in the LDCT arm and 1,186 in the control arm. Their median age was 64.0 years (interquartile range, 5), and median smoking exposure was 45.0 pack-years. The median follow-up was 8.35 years. One hundred four patients (8.23%) were diagnosed with lung cancer in the screening arm (66 by CT), 47 of whom (3.71%) had stage I disease; 72 control patients (6.07%) were diagnosed with lung cancer, with 16 (1.35%) being stage I cases. Lung cancer mortality was 543 per 100,000 person-years (95% confidence interval, 413-700) in the LDCT arm versus 544 per 100,000 person-years (95% CI, 410-709) in the control arm (hazard ratio, 0.993; 95% confidence interval, 0.688-1.433).CONCLUSIONS: Because of its limited statistical power, the results of the DANTE (Detection And screening of early lung cancer with Novel imaging TEchnology) trial do not allow us to make a definitive statement about the efficacy of LDCT screening. However, they underline the importance of obtaining additional data from randomized trials with intervention-free reference arms before the implementation of population screening.
AB - RATIONALE: Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting.OBJECTIVES: To explore the effect of LDCT screening on lung cancer mortality compared with no screening. Secondary endpoints included incidence, stage, and resectability rates.METHODS: Male smokers of 20+ pack-years, aged 60 to 74 years, underwent a baseline CXR and sputum cytology examination and received five screening rounds with LDCT or a yearly clinical review only in a randomized fashion.MEASUREMENTS AND MAIN RESULTS: A total of 1,264 subjects were enrolled in the LDCT arm and 1,186 in the control arm. Their median age was 64.0 years (interquartile range, 5), and median smoking exposure was 45.0 pack-years. The median follow-up was 8.35 years. One hundred four patients (8.23%) were diagnosed with lung cancer in the screening arm (66 by CT), 47 of whom (3.71%) had stage I disease; 72 control patients (6.07%) were diagnosed with lung cancer, with 16 (1.35%) being stage I cases. Lung cancer mortality was 543 per 100,000 person-years (95% confidence interval, 413-700) in the LDCT arm versus 544 per 100,000 person-years (95% CI, 410-709) in the control arm (hazard ratio, 0.993; 95% confidence interval, 0.688-1.433).CONCLUSIONS: Because of its limited statistical power, the results of the DANTE (Detection And screening of early lung cancer with Novel imaging TEchnology) trial do not allow us to make a definitive statement about the efficacy of LDCT screening. However, they underline the importance of obtaining additional data from randomized trials with intervention-free reference arms before the implementation of population screening.
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=84938514714&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938514714&partnerID=8YFLogxK
U2 - 10.1164/rccm.201408-1475OC
DO - 10.1164/rccm.201408-1475OC
M3 - Article
C2 - 25760561
AN - SCOPUS:84938514714
VL - 191
SP - 1166
EP - 1175
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 10
ER -