Loading
The British trial that tested a cheap, staged alternative to scanning everyone, and found it did not work: more than half the cancers never showed up in the sputum at all.
Lung-SEARCH asked whether a cheap first test could be used to decide who needs an expensive one. It randomised 1,568 current and former smokers with mild or moderate chronic obstructive pulmonary disease to five years of annual sputum cytology and cytometry, with low-dose CT and autofluorescence bronchoscopy reserved for those with abnormal sputum, or to nothing. Of those screened, 42 of 785 developed lung cancer against 36 of 783 controls. Early-stage disease accounted for 54.8 percent of the screened arm's cancers against 45.2 percent of the control arm's, a difference that did not reach significance.
The mechanism failed rather than the idea: sputum sensitivity was only 40.5 percent with a cumulative false-positive rate of 32.8 percent, and 55 percent of the cancers had normal sputum throughout. Among people who did have positive sputum, CT was 100 percent sensitive. The authors concluded that the sequential strategy did not lead to a clear stage shift and did not improve the efficiency of screening, which is part of why the UK went to risk-model selection and direct CT instead.
Shares UKLS, University College London Hospitals / UCL Cancer Institute, Low-dose CT lung screening, Lung cancer (all types) and the tags uk, screening, lung.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, screening, lung.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, screening, lung.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, screening, lung.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, lung.
Shares UKLS, Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tag uk.
Shares Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, screening, lung.
Shares Low-dose CT lung screening, Lung cancer (all types), Non-small-cell lung cancer and the tags uk, screening, lung.