CT screening for lung cancer: not ready for routine practice.

Lung cancer continues to be a major worldwide health problem. Multiple strategies are being explored in an attempt to reduce lung cancer mortality, including a renewed interest in screening. Multiple low-dose spiral computed tomography (CT) trials have been proposed, as proponents predict that small nodules will represent early-stage disease and detecting them will ultimately translate into improvements in outcomes. At this time, however, only prevalence-screening data are available, and it remains to be seen if CT will truly reduce mortality. The appropriate hypothesis-driven studies still must be performed and the results carefully analyzed before CT screening for lung cancer can be accepted as the standard of care.

[1]  R C Young,et al.  Combination versus single agent chemotherapy: A review of the basis for selection of drug treatment of cancer , 1975, Cancer.

[2]  B J Flehinger,et al.  Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Memorial Sloan-Kettering study. , 2015, The American review of respiratory disease.

[3]  W F Taylor,et al.  Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. , 2015, The American review of respiratory disease.

[4]  E. Patz,et al.  Identification of small lung nodules at autopsy: implications for lung cancer screening and overdiagnosis bias. , 2001, Lung cancer.

[5]  Melamed Mr,et al.  Current status of screening for lung cancer. , 1994 .

[6]  R. Jain,et al.  Cells shed from tumours show reduced clonogenicity, resistance to apoptosis, and in vivo tumorigenicity , 1999, British Journal of Cancer.

[7]  Feng Li,et al.  Mass screening for lung cancer with mobile spiral computed tomography scanner , 1998, The Lancet.

[8]  H. Welch,et al.  Screening for disease. , 1997, AJR. American journal of roentgenology.

[9]  J. Shih,et al.  Detection and quantitation of circulating cancer cells in the peripheral blood of lung cancer patients. , 1998, Cancer research.

[10]  J Polák,et al.  Lung cancer detection results of a randomized prospective study in Czechoslovakia , 1986, Cancer.

[11]  H. Shimada,et al.  Widespread skeletal metastatic potential of human lung cancer revealed by green fluorescent protein expression. , 1998, Cancer research.

[12]  R. Kerbel,et al.  Consequences of angiogenesis for tumor progression, metastasis and cancer therapy. , 1995, Anti-cancer drugs.

[13]  K. Pantel,et al.  Frequency and prognostic significance of isolated tumour cells in bone marrow of patients with non-small-cell lung cancer without overt metastases , 1996, The Lancet.

[14]  P C Goodman,et al.  Correlation of tumor size and survival in patients with stage IA non-small cell lung cancer. , 2000, Chest.

[15]  J. Jen,et al.  Comparison of oncogene mutation detection and telomerase activity for the molecular staging of non-small cell lung cancer. , 1997, Clinical cancer research : an official journal of the American Association for Cancer Research.

[16]  L. Sobin,et al.  Classification of isolated tumor cells and micrometastasis , 2000 .

[17]  W C Black,et al.  Overdiagnosis: An underrecognized cause of confusion and harm in cancer screening. , 2000, Journal of the National Cancer Institute.

[18]  J. Folkman Clinical Applications of Research on Angiogenesis , 1995 .

[19]  Melvyn S. Tockman,et al.  Survival and Mortality from Lung Cancer in a Screened Population: The Johns Hopkins Study , 1986 .

[20]  M. Melamed,et al.  The National Cancer Institute Cooperative Early Lung Cancer Detection Program. Results of the initial screen (prevalence). Early lung cancer detection: Introduction. , 1984, The American review of respiratory disease.

[21]  D. Spodick The Swan-Ganz catheter: requesting scientific trials is not an "assault". , 1999, Chest.

[22]  P C Prorok,et al.  Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up. , 2000, Journal of the National Cancer Institute.

[23]  J. Jett,et al.  Early detection of lung cancer: Today's approach , 1998 .

[24]  Taylor Murray,et al.  Cancer statistics, 2000 , 2000, CA: a cancer journal for clinicians.

[25]  E. Bergstralh,et al.  Screening for lung cancer. A critique of the mayo lung project , 1991, Cancer.

[26]  J. Izbicki,et al.  Immunohistochemical assessment of individual tumor cells in lymph nodes of patients with non-small-cell lung cancer. , 1994, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  H Nakata,et al.  Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time. , 2000, AJR. American journal of roentgenology.

[28]  O. Miettinen,et al.  Early Lung Cancer Action Project: overall design and findings from baseline screening , 1999, The Lancet.

[29]  J. Izbicki,et al.  Detection of disseminated lung cancer cells in lymph nodes: impact on staging and prognosis. , 1996, The Annals of thoracic surgery.

[30]  G. Strauss,et al.  Lung cancer screening and the surgical oncologist: the controversy. , 1999, Surgical oncology clinics of North America.

[31]  W. C. Ball,et al.  Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. , 2015, The American review of respiratory disease.

[32]  A. Cochran,et al.  Frequency and distribution of occult micrometastases in lymph nodes of patients with non-small-cell lung carcinoma. , 1993, Journal of the National Cancer Institute.

[33]  D. Sugarbaker,et al.  Screening for Lung Cancer: Another Look; A Different View , 1997 .

[34]  W. Whitmore Natural history of low-stage prostatic cancer and the impact of early detection. , 1990, The Urologic clinics of North America.

[35]  J. Herndon,et al.  Stage distribution in patients with a small (< or = 3 cm) primary nonsmall cell lung carcinoma. Implication for lung carcinoma screening. , 2001, Cancer.

[36]  C. Wells,et al.  More lung cancer but better survival. Implications of secular trends in "necropsy surprise" rates. , 1989, Chest.

[37]  B. Hulka Cancer screening degrees of proof and practical application , 1988, Cancer.

[38]  G. Canellos Selection bias in trials of transplantation for metastatic breast cancer: have we picked the apple before it was ripe? , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[39]  Clive R. Taylor,et al.  Detection of occult bone marrow micrometastases in patients with operable lung carcinoma. , 1995 .

[40]  L. Liotta,et al.  Quantitative relationships of intravascular tumor cells, tumor vessels, and pulmonary metastases following tumor implantation. , 1974, Cancer research.

[41]  H. Ohmatsu,et al.  Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. , 1996, Radiology.