Screening for lung cancer in a fixed population by biennial chest radiography

All screening radiographs of the chest and other medical records of 107 patients with histologically proved lung cancer in a fixed population were reviewed to assess the efficacy of biennial chest radiography in detecting lung cancer. Radiographic abnormalities caused by tumors were initially detected in 58 patients (54%); the other 49 (46%) were detected radiographically in subsequent examinations. Thirty-six of the 40 solitary tumors were less than or equal to 4.0 cm in diameter when detected. There were no symptoms in 76% of cases, possibly associated with the predominance of peripheral adenocarcinomas. Routine 36 X 43-cm radiographs, postero-anterior stereoscopic and lateral projections, and comparison with previous radiographs facilitated detection of relatively small tumors in asymptomatic patients. The corrected 5-year survival rate from the time of detection was 20%.