Lung cancer mortality reduction by LDCT screening—Results from the randomized German LUSI trial
-
- Nikolaus Becker
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany
-
- Erna Motsch
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany
-
- Anke Trotter
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany
-
- Claus P. Heussel
- Department of Radiology Thoraxklinik Heidelberg, Heidelberg University Heidelberg Germany
-
- Hendrik Dienemann
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC) Heidelberg Germany
-
- Philipp A. Schnabel
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC) Heidelberg Germany
-
- Hans‐Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology Heidelberg University Clinic Heidelberg Germany
-
- Sandra González Maldonado
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany
-
- Anthony B. Miller
- Dalla Lana School of Public Health University of Toronto Toronto ON Canada
-
- Rudolf Kaaks
- Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany
-
- Stefan Delorme
- Member of the German Center for Lung Research (DZL), Translational Lung Research Center (TLRC) Heidelberg Germany
抄録
<jats:p>In 2011, the U.S. National Lung Cancer Screening Trial (NLST) reported a 20% reduction of lung cancer mortality after regular screening by low‐dose computed tomography (LDCT), as compared to X‐ray screening. The introduction of lung cancer screening programs in Europe awaits confirmation of these first findings from European trials that started in parallel with the NLST. The German Lung cancer Screening Intervention (LUSI) is a randomized trial among 4,052 long‐term smokers, 50–69 years of age, recruited from the general population, comparing five annual rounds of LDCT screening (screening arm; <jats:italic>n</jats:italic> = 2,029 participants) with a control arm (<jats:italic>n</jats:italic> = 2,023) followed by annual postal questionnaire inquiries. Data on lung cancer incidence and mortality and vital status were collected from hospitals or office‐based physicians, cancer registries, population registers and health offices. Over an average observation time of 8.8 years after randomization, the hazard ratio for lung cancer mortality was 0.74 (95% CI: 0.46–1.19; <jats:italic>p</jats:italic> = 0.21) among men and women combined. Modeling by sex, however showed a statistically significant reduction in lung cancer mortality among women (HR = 0.31 [95% CI: 0.10–0.96], <jats:italic>p</jats:italic> = 0.04), but not among men (HR = 0.94 [95% CI: 0.54–1.61], <jats:italic>p</jats:italic> = 0.81) screened by LDCT (<jats:italic>p</jats:italic><jats:sub>heterogeneity</jats:sub> = 0.09). Findings from LUSI are in line with those from other trials, including NLST, that suggest a stronger reduction of lung cancer mortality after LDCT screening among women as compared to men. This heterogeneity could be the result of different relative counts of lung tumor subtypes occurring in men and women.</jats:p>
収録刊行物
-
- International Journal of Cancer
-
International Journal of Cancer 146 (6), 1503-1513, 2019-06-20
Wiley