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Communications to the Editor |

CT Screening for Early Stage Lung Cancer FREE TO VIEW

John H. M. Austin, MD, FCCP; Gregory D. N. Pearson, MD, PhD; Byron Thomashow, MD, FCCP
Author and Funding Information

Columbia Presbyterian Medical Center New York, NY

Correspondence to: John H. M. Austin, MD, FCCP, Division of Thoracic Imaging, Columbia Presbyterian Medical Center, 622 West 168th St, New York, NY 10032; e-mail: jha3@columbia.edu



Chest. 2002;121(5):1725-1726. doi:10.1378/chest.121.5.1725
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To the Editor:

CT screening for “early” lung cancer is a topic under current investigation in an increasing number of centers worldwide. However, a number of centers have already reported the results of chest CT scanning in the assessment of candidates for surgical management of pulmonary emphysema. To our knowledge, six series have reported rates of discovery of stage I lung carcinoma at CT evaluation of these subjects (Table 1 ). Combining the data of these studies, CT-detected stage I and stages II through IV carcinoma of the lung showed overall prevalences of 3.0% and 0.7%, respectively. These prevalences differ significantly (χ2 = 16.0, p < 0.01); the proportions of stage I vs stages II-IV cancers in the six series are homogeneous (χ2 = 4.67, p = 0.46, not significant [NS], and χ2 = 4.45, p = 0.49, NS, respectively), ie, the differences among the series can be regarded as chance fluctuations. %These results, obtained from populations who were fit to undergo thoracic surgery and in the age range for which lung cancer is common, support the concept that CT screening for early stages of lung cancer may prove efficacious.

Table Graphic Jump Location
Table 1. Prevalence of Lung Cancer at CT Scanning in Patients With Pulmonary Emphysema Undergoing Evaluation for Either Lung Transplantation or Lung Volume Reduction Surgery*
* 

Data are presented as No. (%) unless otherwise indicated.

 

χ2 = 16.0, p < 0.01.

Kazerooni, EA, Chow, LC, Whyte, RI, et al (1995) Preoperative examination of lung transplant candidates: value of chest CT compared with chest radiography.AJR Am J Roentgenol165,1343-1348. [PubMed]
 
McKenna, RJ, Jr, Fischel, RJ, Brenner, M, et al Combined operations for lung volume reduction surgery and lung cancer.Chest1996;110,885-888. [PubMed] [CrossRef]
 
Pigula, FA, Keenan, RJ, Ferson, PF, et al Unsuspected lung cancer found in work-up for lung reduction operation.Ann Thorac Surg1996;61,174-176. [PubMed]
 
Hazelrigg, SR, Boley, TM, Weber, D, et al Incidence of lung nodules found in patients undergoing lung volume reduction.Ann Thorac Surg1997;64,303-306. [PubMed]
 
Duarte, IG, Gal, AA, Mansour, KA, et al Pathologic findings in lung volume reduction surgery.Chest1998;113,660-664. [PubMed]
 
Rozenshtein, A, White, CS, Austin, JHM, et al Incidental lung carcinoma detected at CT in patients selected for lung volume reduction surgery to treat severe pulmonary emphysema.Radiology1998;207,487-490. [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1. Prevalence of Lung Cancer at CT Scanning in Patients With Pulmonary Emphysema Undergoing Evaluation for Either Lung Transplantation or Lung Volume Reduction Surgery*
* 

Data are presented as No. (%) unless otherwise indicated.

 

χ2 = 16.0, p < 0.01.

References

Kazerooni, EA, Chow, LC, Whyte, RI, et al (1995) Preoperative examination of lung transplant candidates: value of chest CT compared with chest radiography.AJR Am J Roentgenol165,1343-1348. [PubMed]
 
McKenna, RJ, Jr, Fischel, RJ, Brenner, M, et al Combined operations for lung volume reduction surgery and lung cancer.Chest1996;110,885-888. [PubMed] [CrossRef]
 
Pigula, FA, Keenan, RJ, Ferson, PF, et al Unsuspected lung cancer found in work-up for lung reduction operation.Ann Thorac Surg1996;61,174-176. [PubMed]
 
Hazelrigg, SR, Boley, TM, Weber, D, et al Incidence of lung nodules found in patients undergoing lung volume reduction.Ann Thorac Surg1997;64,303-306. [PubMed]
 
Duarte, IG, Gal, AA, Mansour, KA, et al Pathologic findings in lung volume reduction surgery.Chest1998;113,660-664. [PubMed]
 
Rozenshtein, A, White, CS, Austin, JHM, et al Incidental lung carcinoma detected at CT in patients selected for lung volume reduction surgery to treat severe pulmonary emphysema.Radiology1998;207,487-490. [PubMed]
 
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