Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience.

Abstract

Lung cancer screening with low-dose computed tomography (LDCT) is one of the most promising tools for reducing mortality from lung cancer. The aim of the study was to evaluate the results of an open-access lung cancer screening program with LDCT. In total, 8649 asymptomatic volunteers between 50 and 75 years of age with a smoking history of at least 20 pack-years underwent LDCT screening. The presence of lung nodules with a diameter of less than 5 mm required a follow-up control visit after 12 months, and with a diameter of 5 to 10 mm--after 3, 6, and 12 months. Patients with a nodule of more than 10 mm in diameter required further diagnostic workup. Lung nodules were detected in 4694 individuals (54%). Lung cancer was diagnosed in 107 patients (1.24%). Of 8649 participants, 300 (3.5%) were referred for further diagnostic workup, and 125 (1.5%) underwent surgical resection (81 because of malignant lesions; 44, benign lesions). Eighty-one participants (75%) underwent surgery with a curative intent, and 26 participants underwent oncological treatment. There were no perioperative deaths. The majority of surgical patients underwent lobectomy (video-assisted, in 30 patients; and open, in 38 patients). Stage I non-small cell lung cancer was detected in 64 of the surgical patients (79%). The detection rate of lung cancer in the screening program with low-dose computed tomography is relatively low but patients were diagnosed at a very early stage of the disease compared with standard clinical practice.