Multidetector-row CT of lung cancer screening.

Abstract

L UNG CANCER IS currently the most common cause of cancer death in men and women in the United States. ~,2 Despite the development of effective multimodality treatments, mortality from primary lung cancer has continued to rise over the past 3 decades; approximately 85% of those who develop lung cancer die from i t) More Americans die from lung cancer than colon, breast, and prostate cancers combined. Small-cell lung cancer accounts for approximately 25% of lung cancers. Small-cell lung cancer is usually a systemic disease at initial presentation because of its aggressive nature with early dissemination throughout the body. Outcome is not improved by screening. Non-small-cell lung cancer (NSCLC) accounts for approximately 75% of all lung cancers. The prognosis in patients with NSCLC follows surgical stage at the time of diagnosis. Overall, 5-year survival from lung cancer remains less than 15%3; however, patients with surgically resected early-stage NSCLC have 5-year survival rates of up to 70% or more. 4 Five-year survival in a cohort of 598 patients with surgically resected stage I tumors was recently reported as 75%; however, when stratified by TNM tumor classification, patients with T1 tumors fared better than those with T2 tumors, with 5-year survival rates of 82% and 68%, respectively. 4,5 Small tumor size at time of diagnosis and treatment is associated with longer survival, particularly when tumors are less than 1 cm in diameter. This improvement in survival forms the primary rationale for the early detection of lung cancer using multidetector computed tomography (MDCT) screening.