Source: Annual Congress 2002 - Thoracic oncology: clinical management
Disease area: Thoracic oncology

Abstract

Introduction:Lung Cancer is the commonest cause of cancer related death in Ireland, the majority of cases presenting with advanced disease. With high cure rates for Stage 1 disease, early detection offers an enormous survival advantage. The ProActive Lung Cancer Detection (PALCAD)study was designed to investigate the value of low dose chest CT (LDCCT) for early lung cancer detection in a high risk Irish population.
Methods: Patients over 55 years with a minimum 10 pack year smoking history, no prior cancer history and medically fit to undergo lung resection were recruited by local media advertising. Potential recruits were interviewed regarding smoking habits, asbestos exposure and medical history. Subjects underwent LDCCT imaging and non-calcified nodules (NCNs) were investigated according to the guidelines of the ELCAP study (1).
Results: LDCCT was performed on 400 subjects in the initial 12 month study period. Three(0.75%) positive NCNs >10mm were detected - one lost to follow-up, one recent MI - work-up deferred, one lobectomy (NSCLC). 71(17.75%) NCNs <1cm were detected and will be followed up with interval repeat LDCCT. In addition, one Non-Hodgkins Lymphoma was detected. Incidental pathology was noted in 249(62.25%) patients, largely emphysema, bronchiectasis and coronary artery calcification.
Conclusion: The initial experience of LDCCT screening in a high risk Irish population is of a high incidence of nodules but a low yield of lung cancer. This may reflect the high incidence of granulomatous disease in this population. Prospective interval imaging of this cohort may yet result in a higher yield of stage 1 lung cancers.
References:
1. Henschke CI et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet. 1999 Jul 10; 354(9173): 97-105

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Citations should be made in the following way:
R. E. MacRedmond, Palcad Study Group (Dublin, Ireland). Low dose CT scanning for early lung cancer detection in an Irish population - results of baseline. Eur Respir J 2002; 20: Suppl. 38, 1175

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