A randomized study of lung cancer screening with spiral computed tomography: three-year results from the DANTE trial - PubMed (original) (raw)
Randomized Controlled Trial
. 2009 Sep 1;180(5):445-53.
doi: 10.1164/rccm.200901-0076OC. Epub 2009 Jun 11.
Silvio Cavuto, Fabio Romano Lutman, Giorgio Brambilla, Giuseppe Chiesa, Giovanni Ceresoli, Eliseo Passera, Enzo Angeli, Maurizio Chiarenza, Giuseppe Aranzulla, Umberto Cariboni, Valentina Errico, Francesco Inzirillo, Edoardo Bottoni, Emanuele Voulaz, Marco Alloisio, Anna Destro, Massimo Roncalli, Armando Santoro, Gianluigi Ravasi; DANTE Study Group
Collaborators, Affiliations
- PMID: 19520905
- DOI: 10.1164/rccm.200901-0076OC
Randomized Controlled Trial
A randomized study of lung cancer screening with spiral computed tomography: three-year results from the DANTE trial
Maurizio Infante et al. Am J Respir Crit Care Med. 2009.
Abstract
Rationale: Screening for lung cancer with modern imaging technology may decrease lung cancer mortality, but encouraging results have only been obtained in uncontrolled studies.
Objectives: To explore the effect of screening with low-dose spiral computed tomography (LDCT) on lung cancer mortality. Secondary endpoints are incidence, stage at diagnosis, and resectability.
Methods: Male subjects, aged 60 to 75 years, smokers of 20 or more pack-years, were randomized to screening with LDCT or control groups. All participants underwent a baseline, once-only chest X-ray and sputum cytology examination. Screening-arm subjects had LDCT upon accrual to be repeated every year for 4 years, whereas controls had a yearly medical examination only.
Measurements and main results: A total of 2,811 subjects were randomized and 2,472 were enrolled (LDCT, 1,276; control, 1,196). After a median follow-up of 33 months, lung cancer was detected in 60 (4.7%) patients receiving LDCT and 34 (2.8%) control subjects (P = 0.016). Resectability rates were similar in both groups. More patients with stage I disease were detected by LDCT (54 vs. 34%; P = 0.06) and fewer cases were detected in the screening arm due to intercurrent symptoms. However, the number of advanced lung cancer cases was the same as in the control arm. Twenty patients in the LDCT group (1.6%) and 20 controls (1.7%) died of lung cancer, whereas 26 and 25 died of other causes, respectively.
Conclusions: The mortality benefit from lung cancer screening by LDCT might be far smaller than anticipated.
Comment in
- Are we coming full circle for lung cancer screening a second time?
Bepler G. Bepler G. Am J Respir Crit Care Med. 2009 Sep 1;180(5):384-5. doi: 10.1164/rccm.200906-0977ED. Am J Respir Crit Care Med. 2009. PMID: 19700566 No abstract available. - ACP Journal Club. Screening with spiral CT did not reduce lung cancer mortality in older male smokers.
Bezjak A. Bezjak A. Ann Intern Med. 2009 Dec 15;151(12):JC6-11. doi: 10.7326/0003-4819-151-12-200912150-02011. Ann Intern Med. 2009. PMID: 20008747 No abstract available. - Does lung cancer screening with low-dose CT remain promising despite disappointing DANTE results?
Veronesi G, Maisonneuve P, De Pas TM, Bellomi M. Veronesi G, et al. Am J Respir Crit Care Med. 2010 Sep 1;182(5):720-1; author reply 721. doi: 10.1164/ajrccm.182.5.720. Am J Respir Crit Care Med. 2010. PMID: 20802172 No abstract available.
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