Risk group chest X-ray for the early detection of lung cancer

Abstract

In Hungary, one of the most important components of anti-TB fight was the initiation of chest X-ray based obligatory and yearly screening of the population. In the 1970s, approximately the entire adult population was regularly screened for lung diseases. However, with the improvement of TB epidemiology, early detection of lung cancer--as a "byproduct" of X-ray screening--seems to have a growing significance. In the near future, concentration needs to be given to the risk group for lung cancer, namely smokers who are older than 40 years. To demonstrate the advances of the above strategy, we investigated the lung cancer prevalence in Budapest, retrospectively. Based on the data of 2511 patients, we found that 60% of the patients with 5-year survival were identified with screening. The operability rate was 34% in the group of patients identified by screening. This was only 14% in the case of patients who had been identified based on their symptoms at the time of diagnosis. We also found that radical tumor resection offers a significant short-term (3-4 years) survival advantage, because of the long-term recurrence of the tumors, the overall mortality rate remains unchanged in the target population. Based on the current screening data, there is a chance for short-term survival advantage for 5-600 patients in every year. With the screening of the risk population (smokers, >40 years), the operability rate could be improved which, in turn, could offer a prolonged survival for 1100-1200 lung cancer patients.