Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Jul;26(4):324-329.
doi: 10.1097/CEJ.0000000000000264.

Lung cancer screening with low-dose spiral computed tomography: evidence from a pooled analysis of two Italian randomized trials

Affiliations
Randomized Controlled Trial

Lung cancer screening with low-dose spiral computed tomography: evidence from a pooled analysis of two Italian randomized trials

Maurizio Infante et al. Eur J Cancer Prev. 2017 Jul.

Abstract

The benefits and harms of lung cancer (LC) screening with low-dose computed tomography (LDCT) are debatable. Positive results from the US National Lung Screening Trial were not evident in the European trials, possibly due to their smaller sample sizes. To address this issue, we conducted a patient-level pooled analysis of two Italian randomized controlled trials. Data from DANTE and MILD trials were combined for a total of 3640 individuals in the LDCT arm and 2909 in the control arm. LC and overall mortality were analyzed using multivariate hazard ratios (HRs) and log-rank tests stratified by study. The median follow-up was 8.2 years, with a total of 30 480 person-years in the LDCT arm and 22 157 in the control arm. A total of 192 patients developed LC in the LDCT arm and 105 in the control arm. Half of the LC cases in the LDCT arm had stage IA or IB cancer, as compared with 21% in the control arm. Overall mortality rates/100 000 person-years were 925 in the LDCT arm and 1074 in the control arm, and LC mortality rates were 299 and 357, respectively. The multivariate pooled overall mortality HR was 0.89 (95% confidence interval: 0.74-1.06) and the LC mortality HR was 0.83 (95% confidence interval: 0.61-1.12) for the LDCT arm as compared with the control arm. The present pooled analysis shows a nonsignificant 11% reduction in overall mortality in individuals undergoing LDCT screening as compared with the control arm. A pooled analysis of all European trials would be a useful contribution to assess the real benefit of LDCT screening.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Cumulative probability of death from all causes (a) and from lung cancer (b) (Italy, 2001–2011). LDCT, low-dose computed tomography.

References

    1. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409. - PMC - PubMed
    1. Bach PB, Mirkin JN, Oliver TK, Azzoli CG, Berry DA, Brawley OW, et al. (2012). Benefits and harms of CT screening for lung cancer: a systematic review. JAMA 307:2418–2429. - PMC - PubMed
    1. Baldwin DR, Duffy SW, Wald NJ, Page R, Hansell DM, Field JK (2011). UK Lung Screen (UKLS) nodule management protocol: modelling of a single screen randomised controlled trial of low-dose CT screening for lung cancer. Thorax 66:308–313. - PMC - PubMed
    1. Becker N, Motsch E, Gross ML, Eigentopf A, Heussel CP, Dienemann H, et al. (2015). Randomized study on early detection of lung cancer with MSCT in Germany: results of the first 3 years of follow-up after randomization. J Thorac Oncol 10:890–896. - PubMed
    1. Bray FI, Weiderpass E (2010). Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970–2007. Int J Cancer 126:1454–1466. - PubMed

Publication types

MeSH terms