Ten-year results of the Multicentric Italian Lung Detection trial demonstrate the safety and efficacy of biennial lung cancer screening

U. Pastorino, N. Sverzellati, S. Sestini, M. Silva, F. Sabia, M. Boeri, A. Cantarutti, G. Sozzi, G. Corrao, A. Marchianò

Research output: Contribution to journalArticle

Abstract

Background: The Multicentric Italian Lung Detection (MILD) trial demonstrated that prolonged low-dose computed tomography (LDCT) screening could achieve a 39% reduction in lung cancer (LC) mortality. We have here evaluated the long-term results of annual vs. biennial LDCT and the impact of screening intensity on overall and LC-specific mortality at 10 years. Patients and methods: Between 2005 and 2018, the MILD trial prospectively randomised the 2376 screening arm participants to annual (n = 1190) or biennial (n = 1186) LDCT, for a median screening period of 6.2 years and 23,083 person-years of follow-up. The primary outcomes were 10-year overall and LC-specific mortality, and the secondary end-points were the frequency of advanced-stage and interval LCs. Results: The biennial LDCT arm showed a similar overall mortality (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.57–1.12) and LC-specific mortality at 10 years (HR 1.10, 95% CI 0.59–2.05), as compared with the annual LDCT arm. Biennial screening saved 44% of follow-up LDCTs in subjects with negative baseline LDCT, and 38% of LDCTs in all participants, with no increase in the occurrence of stage II-IV or interval LCs. Conclusions: The MILD trial provides original evidence that prolonged screening beyond five years with biennial LDCT can achieve an LC mortality reduction comparable to annual LDCT, in subjects with a negative baseline examination.

Original languageEnglish
Pages (from-to)142-148
Number of pages7
JournalEuropean Journal of Cancer
Volume118
DOIs
Publication statusPublished - Sep 2019

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Keywords

  • Biennial
  • Computed tomography
  • Early detection
  • Interval
  • LDCT
  • Lung cancer
  • Mortality
  • Overdiagnosis
  • Screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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