Lung cancer screening with CT: Mayo clinic experience

Stephen J. Swensen, James R. Jett, Thomas E. Hartman, David E. Midthun, Jeff A. Sloan, Anne Marie Sykes, Gregory L. Aughenbaugh, Medy A. Clemens

Research output: Contribution to journalArticle

545 Scopus citations

Abstract

PURPOSE: To evaluate a large cohort of patients at high risk for lung cancer by using screening with low-dose spiral computed tomography (CT) of the chest. MATERIALS AND METHODS: A prospective cohort study was performed with 1,520 individuals aged 50 years or older who had smoked 20 pack-years or more. Participants underwent three annual low-dose CT examinations of the chest and upper abdomen. Characteristics of pulmonary nodules and additional findings were tabulated and analyzed. RESULTS: Two years after baseline CT scanning, 2,832 uncalcified pulmonary nodules were identified in 1,049 participants (69%). Forty cases of lung cancer were diagnosed: 26 at baseline (prevalence) CT examinations and 10 at subsequent annual (incidence) CT examinations. CT alone depicted 36 cases; sputum cytologic examination alone, two. There were two interval cancers. Cell types were as follows: squamous cell tumor, seven; adenocarcinoma or bronchioloalveolar carcinoma, 24; large cell tumor, two; non-small cell tumor, three; small cell tumor, four. The mean size of the non-small cell cancers detected at CT was 15.0 mm. The stages were as follows: IA, 22; IB, three; IIA, four; IIB, one; IIIA, five; IV, one; limited small cell tumor, four. Twenty-one (60%) of the 35 non-small cell cancers detected at CT were stage IA at diagnosis. Six hundred ninety-six additional findings of clinical importance were identified. CONCLUSION: CT can depict early-stage lung cancers. The rate of benign nodule detection is high.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalRadiology
Volume226
Issue number3
DOIs
StatePublished - Mar 1 2003

Keywords

  • Cancer screening
  • Lung neoplasms
  • Smoking

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Swensen, S. J., Jett, J. R., Hartman, T. E., Midthun, D. E., Sloan, J. A., Sykes, A. M., Aughenbaugh, G. L., & Clemens, M. A. (2003). Lung cancer screening with CT: Mayo clinic experience. Radiology, 226(3), 756-761. https://doi.org/10.1148/radiol.2263020036