The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round

Jesper H Pedersen; Haseem Ashraf; Asger Dirksen; Karen Bach; Hanne Hansen; Phillip Toennesen; Hanne Thorsen; John Brodersen; Birgit Guldhammer Skov; Martin Døssing; Jann Mortensen; Klaus Richter; Paul Clementsen; Niels Seersholm

doi:10.1097/JTO.0b013e3181a0d98f

The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round

Jesper H Pedersen, Haseem Ashraf, Asger Dirksen, Karen Bach, Hanne Hansen, Phillip Toennesen, Hanne Thorsen, John Brodersen, Birgit Guldhammer Skov, Martin Døssing, Jann Mortensen, Klaus Richter, Paul Clementsen, Niels Seersholm

291 Citations (Scopus)

Abstract

INTRODUCTION: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. METHODS: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either screening with annual low dose CT scans for 5 years or no screening. A history of cigarette smoking of at least 20 pack years was required. All participants have annual lung function tests, and questionnaires regarding health status, psychosocial consequences of screening, smoking habits, and smoking cessation. Baseline CT scans were performed in 2052 participants. Pulmonary nodules were classified according to size and morphology: (1) Nodules smaller than 5 mm and calcified (benign) nodules were tabulated, (2) Noncalcified nodules between 5 and 15 mm were rescanned after 3 months. If the nodule increased in size or was larger than 15 mm the participant was referred for diagnostic workup. RESULTS: At baseline 179 persons showed noncalcified nodules larger than 5 mm, and most were rescanned after 3 months: The rate of false-positive diagnoses was 7.9%, and 17 individuals (0.8%) turned out to have lung cancer. Ten of these had stage I disease. Eleven of 17 lung cancers at baseline were treated surgically, eight of these by video assisted thoracic surgery resection. CONCLUSIONS: Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.

Original language	English
Journal	Journal of Thoracic Oncology
Volume	4
Issue number	5
Pages (from-to)	608-14
Number of pages	7
ISSN	1556-0864
DOIs	https://doi.org/10.1097/JTO.0b013e3181a0d98f
Publication status	Published - 2009

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10.1097/JTO.0b013e3181a0d98f

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Pedersen, J. H., Ashraf, H., Dirksen, A., Bach, K., Hansen, H., Toennesen, P., Thorsen, H., Brodersen, J., Skov, B. G., Døssing, M., Mortensen, J., Richter, K., Clementsen, P., & Seersholm, N. (2009). The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round. Journal of Thoracic Oncology, 4(5), 608-14. https://doi.org/10.1097/JTO.0b013e3181a0d98f

Pedersen, JH, Ashraf, H, Dirksen, A, Bach, K, Hansen, H, Toennesen, P, Thorsen, H , Brodersen, J, Skov, BG, Døssing, M, Mortensen, J , Richter, K, Clementsen, P & Seersholm, N 2009, 'The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round', Journal of Thoracic Oncology, vol. 4, no. 5, pp. 608-14. https://doi.org/10.1097/JTO.0b013e3181a0d98f

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title = "The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round",

abstract = "INTRODUCTION: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. METHODS: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either screening with annual low dose CT scans for 5 years or no screening. A history of cigarette smoking of at least 20 pack years was required. All participants have annual lung function tests, and questionnaires regarding health status, psychosocial consequences of screening, smoking habits, and smoking cessation. Baseline CT scans were performed in 2052 participants. Pulmonary nodules were classified according to size and morphology: (1) Nodules smaller than 5 mm and calcified (benign) nodules were tabulated, (2) Noncalcified nodules between 5 and 15 mm were rescanned after 3 months. If the nodule increased in size or was larger than 15 mm the participant was referred for diagnostic workup. RESULTS: At baseline 179 persons showed noncalcified nodules larger than 5 mm, and most were rescanned after 3 months: The rate of false-positive diagnoses was 7.9%, and 17 individuals (0.8%) turned out to have lung cancer. Ten of these had stage I disease. Eleven of 17 lung cancers at baseline were treated surgically, eight of these by video assisted thoracic surgery resection. CONCLUSIONS: Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.",

author = "Pedersen, {Jesper H} and Haseem Ashraf and Asger Dirksen and Karen Bach and Hanne Hansen and Phillip Toennesen and Hanne Thorsen and John Brodersen and Skov, {Birgit Guldhammer} and Martin D{\o}ssing and Jann Mortensen and Klaus Richter and Paul Clementsen and Niels Seersholm",

note = "Keywords: Adenocarcinoma; Adult; Aged; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Denmark; Early Detection of Cancer; Epidemiologic Research Design; False Positive Reactions; Female; Humans; Lung Neoplasms; Male; Mass Screening; Middle Aged; Neoplasm Staging; Prevalence; Prognosis; Sensitivity and Specificity; Smoking; Tomography, X-Ray Computed",

year = "2009",

doi = "10.1097/JTO.0b013e3181a0d98f",

language = "English",

volume = "4",

pages = "608--14",

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TY - JOUR

T1 - The Danish randomized lung cancer CT screening trial

T2 - overall design and results of the prevalence round

AU - Pedersen, Jesper H

AU - Ashraf, Haseem

AU - Dirksen, Asger

AU - Bach, Karen

AU - Hansen, Hanne

AU - Toennesen, Phillip

AU - Thorsen, Hanne

AU - Brodersen, John

AU - Skov, Birgit Guldhammer

AU - Døssing, Martin

AU - Mortensen, Jann

AU - Richter, Klaus

AU - Clementsen, Paul

AU - Seersholm, Niels

N1 - Keywords: Adenocarcinoma; Adult; Aged; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; Denmark; Early Detection of Cancer; Epidemiologic Research Design; False Positive Reactions; Female; Humans; Lung Neoplasms; Male; Mass Screening; Middle Aged; Neoplasm Staging; Prevalence; Prognosis; Sensitivity and Specificity; Smoking; Tomography, X-Ray Computed

PY - 2009

Y1 - 2009

N2 - INTRODUCTION: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. METHODS: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either screening with annual low dose CT scans for 5 years or no screening. A history of cigarette smoking of at least 20 pack years was required. All participants have annual lung function tests, and questionnaires regarding health status, psychosocial consequences of screening, smoking habits, and smoking cessation. Baseline CT scans were performed in 2052 participants. Pulmonary nodules were classified according to size and morphology: (1) Nodules smaller than 5 mm and calcified (benign) nodules were tabulated, (2) Noncalcified nodules between 5 and 15 mm were rescanned after 3 months. If the nodule increased in size or was larger than 15 mm the participant was referred for diagnostic workup. RESULTS: At baseline 179 persons showed noncalcified nodules larger than 5 mm, and most were rescanned after 3 months: The rate of false-positive diagnoses was 7.9%, and 17 individuals (0.8%) turned out to have lung cancer. Ten of these had stage I disease. Eleven of 17 lung cancers at baseline were treated surgically, eight of these by video assisted thoracic surgery resection. CONCLUSIONS: Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.

AB - INTRODUCTION: Lung cancer screening with low dose computed tomography (CT) has not yet been evaluated in randomized clinical trials, although several are underway. METHODS: In The Danish Lung Cancer Screening Trial, 4104 smokers and previous smokers from 2004 to 2006 were randomized to either screening with annual low dose CT scans for 5 years or no screening. A history of cigarette smoking of at least 20 pack years was required. All participants have annual lung function tests, and questionnaires regarding health status, psychosocial consequences of screening, smoking habits, and smoking cessation. Baseline CT scans were performed in 2052 participants. Pulmonary nodules were classified according to size and morphology: (1) Nodules smaller than 5 mm and calcified (benign) nodules were tabulated, (2) Noncalcified nodules between 5 and 15 mm were rescanned after 3 months. If the nodule increased in size or was larger than 15 mm the participant was referred for diagnostic workup. RESULTS: At baseline 179 persons showed noncalcified nodules larger than 5 mm, and most were rescanned after 3 months: The rate of false-positive diagnoses was 7.9%, and 17 individuals (0.8%) turned out to have lung cancer. Ten of these had stage I disease. Eleven of 17 lung cancers at baseline were treated surgically, eight of these by video assisted thoracic surgery resection. CONCLUSIONS: Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.

U2 - 10.1097/JTO.0b013e3181a0d98f

DO - 10.1097/JTO.0b013e3181a0d98f

M3 - Journal article

C2 - 19357536

SN - 1556-0864

VL - 4

SP - 608

EP - 614

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

IS - 5

ER -

The Danish randomized lung cancer CT screening trial: overall design and results of the prevalence round

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