Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer

John K. Gohagan, Pamela M. Marcus, Richard M. Fagerstrom, Paul F. Pinsky, Barnett S. Kramer, Philip C. Prorok, Susan Ascher, William Bailey, Brenda Brewer, Timothy Church, Deborah Engelhard, Melissa Ford, Mona Fouad, Matthew Freedman, Edward Gelmann, David Gierada, William Hocking, Subbarao Inampudi, Brian Irons, Christine Cole JohnsonArthur Jones, Gena Kucera, Paul Kvale, Karen Lappe, William Manor, Alisha Moore, Hrudaya Nath, Sarah Neff, Martin Oken, Michael Plunkett, Helen Price, Douglas Reding, Thomas Riley, Martin Schwartz, David Spizarny, Roberta Yoffie, Carl Zylak

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225 Scopus citations

Abstract

The Lung Screening Study (LSS) was a pilot study designed to assess the feasibility of conducting a large scale randomized controlled trial (RCT) of low radiation dose spiral computed tomography (LDCT) versus chest X-ray (CXR) for lung cancer screening. Baseline results of LSS have been previously reported. Here, we report on the findings at the year one screen and on the final results of the LSS study. A total of 1660 subjects were randomized to the LDCT arm and 1658 to the CXR arm. Compliance with screening declined from 96% at baseline to 86% at year one in the LDCT arm and declined from 93% at baseline to 80% at year one in the CXR arm. Positivity rates for the year one screen were 25.8% for LDCT and 8.7% for CXR. Cancer yield was significantly less at year one for LDCT, 0.57%, than at baseline, 1.9%; cancer yield for CXR increased from 0.45% at baseline to 0.68% at year one. Forty lung cancers in the LDCT arm and 20 in the CXR arm were diagnosed over the study period. Stage I cancers comprised 48% of cases in the LDCT arm and 40% in the CXR arm. A total of 16 stage III-IV cancers were observed in the LDCT arm versus nine in the CXR arm. The LSS has established the feasibility of a RCT comparing annual spiral CT to chest X-ray for lung cancer screening.

Original languageEnglish (US)
Pages (from-to)9-15
Number of pages7
JournalLung Cancer
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2005

Keywords

  • Chest X-ray
  • Lung cancer
  • Randomized trial
  • Screening
  • Spiral CT

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    Gohagan, J. K., Marcus, P. M., Fagerstrom, R. M., Pinsky, P. F., Kramer, B. S., Prorok, P. C., Ascher, S., Bailey, W., Brewer, B., Church, T., Engelhard, D., Ford, M., Fouad, M., Freedman, M., Gelmann, E., Gierada, D., Hocking, W., Inampudi, S., Irons, B., ... Zylak, C. (2005). Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer. Lung Cancer, 47(1), 9-15. https://doi.org/10.1016/j.lungcan.2004.06.007