Abstract
Objective. To evaluate the feasibility of using low-dose computed tomography (LDCT) for the early diagnosis of lung cancer and malignant pleural mesothelioma in an asbestos-exposed population. Methods. Between February 2002 and October 2003, 1,045 volunteers already enrolled in a surveillance program for asbestos-exposed workers and former workers were recruited. The main eligibility criteria were: written informed consent, definite exposure to asbestos, age 40-75, no prior cancer or severe concomitant conditions, no chest CT scan in the past 2 years. A smoking history was not required. After a structured interview, chest X-ray (CXR) and LDCT were performed. Participants with negative examinations were assigned to annual LDCT. Participants with positive findings received high-resolution CT and additional diagnostic workup as appropriate. Results. Baseline characteristics of the screened population were: median asbestos exposure time, 30 years; median age, 58; median pack-years in smokers/former smokers, 18.5. Thirty-four percent had never smoked. On LDCT, 834 noncalcified nodules were identified in 44% of participants, versus 43 nodules in 4% on CXR. Pleural abnormalities were observed in 44% and 70% of participants by CXR and LDCT, respectively. Overall, LDCT identified nine cases of non-small cell lung cancer - eight stage I, one stage IIA - and one thymic carcinoid, corresponding to 1% of the enrolled population. All cases were radically treated. None had been detected by CXR. No pleural mesothelioma was diagnosed. There were 11 false-positive results. Conclusions. Our findings first suggest that LDCT may be at least as useful in asbestos workers as in heavy smokers for the early diagnosis of lung cancer; this benefit is evident even in a poor-risk population, with low rates of smoking prevalence and a previous history of radiological surveillance. The role of spiral tomography in screening for pleural mesothelioma remains uncertain.
| Original language | English |
|---|---|
| Pages (from-to) | 1215-1224 |
| Number of pages | 10 |
| Journal | The oncologist |
| Volume | 12 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2007 |
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Keywords
- Asbestos
- Lung cancer
- Malignant pleural mesothelioma
- Occupational exposure
- Screening
- Spiral computed tomography
ASJC Scopus subject areas
- Cancer Research
- Hematology
Cite this
Low-dose computed tomography screening for lung cancer and pleural mesothelioma in an asbestos-exposed population : Baseline results of a prospective, nonrandomized feasibility trial - An alpe-adria thoracic oncology multidisciplinary group study (ATOM 002). / Fasola, Gianpiero; Belvedere, Ornella; Aita, Marianna; Zanin, Tina; Follador, Alessandro; Cassetti, Paolo; Meduri, Stefano; De Pangher, Vincenzo; Pignata, Giusto; Rosolen, Valentina; Barbone, Fabio; Grossi, Francesco.
In: The oncologist, Vol. 12, No. 10, 10.2007, p. 1215-1224.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Low-dose computed tomography screening for lung cancer and pleural mesothelioma in an asbestos-exposed population
T2 - Baseline results of a prospective, nonrandomized feasibility trial - An alpe-adria thoracic oncology multidisciplinary group study (ATOM 002)
AU - Fasola, Gianpiero
AU - Belvedere, Ornella
AU - Aita, Marianna
AU - Zanin, Tina
AU - Follador, Alessandro
AU - Cassetti, Paolo
AU - Meduri, Stefano
AU - De Pangher, Vincenzo
AU - Pignata, Giusto
AU - Rosolen, Valentina
AU - Barbone, Fabio
AU - Grossi, Francesco
PY - 2007/10
Y1 - 2007/10
N2 - Objective. To evaluate the feasibility of using low-dose computed tomography (LDCT) for the early diagnosis of lung cancer and malignant pleural mesothelioma in an asbestos-exposed population. Methods. Between February 2002 and October 2003, 1,045 volunteers already enrolled in a surveillance program for asbestos-exposed workers and former workers were recruited. The main eligibility criteria were: written informed consent, definite exposure to asbestos, age 40-75, no prior cancer or severe concomitant conditions, no chest CT scan in the past 2 years. A smoking history was not required. After a structured interview, chest X-ray (CXR) and LDCT were performed. Participants with negative examinations were assigned to annual LDCT. Participants with positive findings received high-resolution CT and additional diagnostic workup as appropriate. Results. Baseline characteristics of the screened population were: median asbestos exposure time, 30 years; median age, 58; median pack-years in smokers/former smokers, 18.5. Thirty-four percent had never smoked. On LDCT, 834 noncalcified nodules were identified in 44% of participants, versus 43 nodules in 4% on CXR. Pleural abnormalities were observed in 44% and 70% of participants by CXR and LDCT, respectively. Overall, LDCT identified nine cases of non-small cell lung cancer - eight stage I, one stage IIA - and one thymic carcinoid, corresponding to 1% of the enrolled population. All cases were radically treated. None had been detected by CXR. No pleural mesothelioma was diagnosed. There were 11 false-positive results. Conclusions. Our findings first suggest that LDCT may be at least as useful in asbestos workers as in heavy smokers for the early diagnosis of lung cancer; this benefit is evident even in a poor-risk population, with low rates of smoking prevalence and a previous history of radiological surveillance. The role of spiral tomography in screening for pleural mesothelioma remains uncertain.
AB - Objective. To evaluate the feasibility of using low-dose computed tomography (LDCT) for the early diagnosis of lung cancer and malignant pleural mesothelioma in an asbestos-exposed population. Methods. Between February 2002 and October 2003, 1,045 volunteers already enrolled in a surveillance program for asbestos-exposed workers and former workers were recruited. The main eligibility criteria were: written informed consent, definite exposure to asbestos, age 40-75, no prior cancer or severe concomitant conditions, no chest CT scan in the past 2 years. A smoking history was not required. After a structured interview, chest X-ray (CXR) and LDCT were performed. Participants with negative examinations were assigned to annual LDCT. Participants with positive findings received high-resolution CT and additional diagnostic workup as appropriate. Results. Baseline characteristics of the screened population were: median asbestos exposure time, 30 years; median age, 58; median pack-years in smokers/former smokers, 18.5. Thirty-four percent had never smoked. On LDCT, 834 noncalcified nodules were identified in 44% of participants, versus 43 nodules in 4% on CXR. Pleural abnormalities were observed in 44% and 70% of participants by CXR and LDCT, respectively. Overall, LDCT identified nine cases of non-small cell lung cancer - eight stage I, one stage IIA - and one thymic carcinoid, corresponding to 1% of the enrolled population. All cases were radically treated. None had been detected by CXR. No pleural mesothelioma was diagnosed. There were 11 false-positive results. Conclusions. Our findings first suggest that LDCT may be at least as useful in asbestos workers as in heavy smokers for the early diagnosis of lung cancer; this benefit is evident even in a poor-risk population, with low rates of smoking prevalence and a previous history of radiological surveillance. The role of spiral tomography in screening for pleural mesothelioma remains uncertain.
KW - Asbestos
KW - Lung cancer
KW - Malignant pleural mesothelioma
KW - Occupational exposure
KW - Screening
KW - Spiral computed tomography
UR - http://www.scopus.com/inward/record.url?scp=36148971244&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=36148971244&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.12-10-1215
DO - 10.1634/theoncologist.12-10-1215
M3 - Article
C2 - 17962615
AN - SCOPUS:36148971244
VL - 12
SP - 1215
EP - 1224
JO - Oncologist
JF - Oncologist
SN - 1083-7159
IS - 10
ER -