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Related Experiment Videos

Screening for lung cancer.

R L Manser1, L B Irving, C Stone

  • 1Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria, Australia, 3050. ManserRL@mh.org.au

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary
This summary is machine-generated.

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Current lung cancer screening methods like chest radiography and sputum cytology lack proven effectiveness. Frequent chest x-ray screening may even increase lung cancer mortality, necessitating further rigorous trials.

Area of Science:

  • Oncology
  • Public Health
  • Diagnostic Imaging

Background:

  • The effectiveness of lung cancer screening modalities, including chest radiography, sputum cytology, and spiral CT, remains unestablished.
  • Existing evidence does not definitively support these methods for reducing lung cancer mortality.

Purpose of the Study:

  • To evaluate whether regular screening for lung cancer using sputum examinations, chest radiography, or CT chest can decrease lung cancer mortality.
  • To synthesize evidence from controlled trials on the efficacy of lung cancer screening interventions.

Main Methods:

  • A comprehensive search of electronic databases, bibliographies, and expert consultations identified relevant published and unpublished trials.
  • Included were controlled trials assessing screening for lung cancer via sputum examination, chest radiography, or CT chest.

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  • Intention-to-screen analysis was conducted, employing random-effect models for significant heterogeneity and fixed-effect models otherwise.

    • Main Results:

    • Seven trials (6 randomized, 1 non-randomized) involving 245,610 subjects were analyzed; none had an unscreened control group.
    • Frequent chest x-ray screening showed an 11% relative increase in lung cancer mortality compared to less frequent screening (RR 1.11, CI: 1.00-1.23).
    • A trend towards reduced lung cancer mortality was observed with combined chest x-ray and sputum cytology versus chest x-ray alone (RR 0.88, CI: 0.74-1.03), though not statistically significant. No controlled studies on spiral CT were found.

    Conclusions:

    • Current evidence does not support the use of chest radiography or sputum cytology for lung cancer screening.
    • Frequent chest x-ray screening may potentially be harmful.
    • There is a need for further methodologically rigorous trials to establish effective lung cancer screening strategies.