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Original Research: Lung Cancer |

Chest CT Scan Screening for Lung Cancer in Asbestos Occupational ExposureCT Scan Screening in Asbestos-Exposed Workers: A Systematic Review and Meta-analysis

Marie Ollier, MD; Alain Chamoux, MD, PhD; Geraldine Naughton, PhD; Bruno Pereira, PhD; Frédéric Dutheil, MD, PhD
Author and Funding Information

From the Department of Occupational Medicine (Drs Ollier, Chamoux, and Dutheil), the Clinical Research and Innovation Direction (Dr Pereira), Sport Medicine and Functional Exploration (Dr Dutheil), University Hospital CHU G. Montpied, Clermont-Ferrand, France; the Laboratory of Molecular Oncology EA 4677 (Dr Ollier), Centre Jean Perrin, Clermont-Ferrand, France; the School of Exercise Science (Drs Naughton and Dutheil), Australian Catholic University, Fitzroy, VIC, Australia; the Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533 (Dr Dutheil), Blaise Pascal University, Clermont-Ferrand, France; and INRA UMR 1019 (Dr Dutheil), UNH, CRNH Auvergne, University of Auvergne, Clermont-Ferrand, France.

Correspondence to: Frédéric Dutheil, MD, PhD, Occupational Medicine, University Hospital CHU G. Montpied, 58 rue Montalembert, 63 000 Clermont-Ferrand, France; e-mail: fred_dutheil@yahoo.fr


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1339-1346. doi:10.1378/chest.13-2181
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Objective:  Lung cancer is the most frequent malignant asbestos-related pathology and remains the most fatal cancer of industrialized countries. In heavy smokers, early detection of lung cancer with chest CT scan leads to a 20% mortality reduction. However, the use of CT scan screening for early detection of lung cancer in asbestos-exposed workers requires further investigation. This study aimed to determine whether CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer using a systematic review and meta-analysis.

Methods:  We reviewed all cohort studies involving chest CT scan screening in former asbestos-exposed workers. The search strategy used the following keywords: “asbestos,” “lung cancer,” “screening,” and “occupation*” or “work.” Databases were PubMed, Cochrane Library, Science Direct, and Embase.

Results:  Seven studies matched our inclusion criteria. Baseline screening detected 49 asymptomatic lung cancers among 5,074 asbestos-exposed workers. Of the 49 reported lung cancers, at least 18 were in the earliest stage (stage I), accessible to complete removal surgery. The prevalence of all lung cancers detected by CT scan screening in asbestos-exposed workers was 1.1% (95% CI, 0.6%-1.8%).

Conclusions:  CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer. Detection of lung cancer in asbestos-exposed workers using CT scanning is at least equal to the prevalence in heavy smokers (1%; 95% CI, 0.09%-1.1%) and also shared a similar proportion of stage I diagnoses. Screening asbestos-exposed workers could reduce mortality in proportions previously observed among heavy smokers and, thus, should not be neglected, particularly for individuals combining both exposures.

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