Computed tomography screening for lung cancer: prospects of surviving competing causes of death

The primary objective of this study was to shed light on the frequency of death from a "competing" cause among persons who enter into computed tomography (CT) screening for lung cancer and to determine the 5- and 10-year rates of death from causes other than lung cancer in a cohort of older smokers and former smokers with the initiation of CT screening for lung cancer.

We followed a cohort of 2141 men and women aged 60-75 years with a history of 30-100 pack-years of cigarette smoking who enrolled for CT screening for lung cancer in 1993-2004. The National Death Index retrieval program was used to identify all deaths and causes of death. Follow-up time from the date of the initial CT to death, loss to follow-up, or December 31, 2004, whichever came first, was calculated for each subject. Median duration of follow-up was 50 months (range, 1-133 months). Kaplan-Meier analysis was used to derive the 5- and 10-year survival rates with the exclusion of deaths from lung cancer.

The 5- and 10-year survival rates, conditional on not dying from lung cancer, were 96% and 90.7%, respectively. The corresponding 95% confidence intervals were 95%-97% and 88.2%-95.2%, respectively.

Older smokers and former smokers seeking and receiving CT screening for lung cancer have a low 10-year risk of dying from causes other than lung cancer, and early treatment of screen-diagnosed cancer can be life-saving.