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.
Similar articles
- Long-Term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography.
Infante M, Cavuto S, Lutman FR, Passera E, Chiarenza M, Chiesa G, Brambilla G, Angeli E, Aranzulla G, Chiti A, Scorsetti M, Navarria P, Cavina R, Ciccarelli M, Roncalli M, Destro A, Bottoni E, Voulaz E, Errico V, Ferraroli G, Finocchiaro G, Toschi L, Santoro A, Alloisio M; DANTE Study Group. Infante M, et al. Am J Respir Crit Care Med. 2015 May 15;191(10):1166-75. doi: 10.1164/rccm.201408-1475OC. Am J Respir Crit Care Med. 2015. PMID: 25760561 Clinical Trial. - Lung cancer screening with spiral CT: baseline results of the randomized DANTE trial.
Infante M, Lutman FR, Cavuto S, Brambilla G, Chiesa G, Passera E, Angeli E, Chiarenza M, Aranzulla G, Cariboni U, Alloisio M, Incarbone M, Testori A, Destro A, Cappuzzo F, Roncalli M, Santoro A, Ravasi G; DANTE Study Group. Infante M, et al. Lung Cancer. 2008 Mar;59(3):355-63. doi: 10.1016/j.lungcan.2007.08.040. Epub 2007 Oct 23. Lung Cancer. 2008. PMID: 17936405 Clinical Trial. - Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial.
Pastorino U, Rossi M, Rosato V, Marchianò A, Sverzellati N, Morosi C, Fabbri A, Galeone C, Negri E, Sozzi G, Pelosi G, La Vecchia C. Pastorino U, et al. Eur J Cancer Prev. 2012 May;21(3):308-15. doi: 10.1097/CEJ.0b013e328351e1b6. Eur J Cancer Prev. 2012. PMID: 22465911 Clinical Trial. - Computed tomography screening for lung cancer: has it finally arrived? Implications of the national lung screening trial.
Aberle DR, Abtin F, Brown K. Aberle DR, et al. J Clin Oncol. 2013 Mar 10;31(8):1002-8. doi: 10.1200/JCO.2012.43.3110. Epub 2013 Feb 11. J Clin Oncol. 2013. PMID: 23401434 Free PMC article. Review. - A meta-analysis: is low-dose computed tomography a superior method for risky lung cancers screening population?
Fu C, Liu Z, Zhu F, Li S, Jiang L. Fu C, et al. Clin Respir J. 2016 May;10(3):333-41. doi: 10.1111/crj.12222. Epub 2014 Nov 26. Clin Respir J. 2016. PMID: 25307063 Review.
Cited by
- Impact of endoscopic surveillance on mortality from Barrett's esophagus-associated esophageal adenocarcinomas.
Corley DA, Mehtani K, Quesenberry C, Zhao W, de Boer J, Weiss NS. Corley DA, et al. Gastroenterology. 2013 Aug;145(2):312-9.e1. doi: 10.1053/j.gastro.2013.05.004. Epub 2013 May 11. Gastroenterology. 2013. PMID: 23673354 Free PMC article. - From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the French intergroup (IFCT) and the groupe d'Oncologie de langue francaise (GOLF).
Couraud S, Cortot AB, Greillier L, Gounant V, Mennecier B, Girard N, Besse B, Brouchet L, Castelnau O, Frappé P, Ferretti GR, Guittet L, Khalil A, Lefebure P, Laurent F, Liebart S, Molinier O, Quoix E, Revel MP, Stach B, Souquet PJ, Thomas P, Trédaniel J, Lemarié E, Zalcman G, Barlési F, Milleron B; French lung cancer screening statement taskforce; groupe d'Oncologie de langue française. Couraud S, et al. Ann Oncol. 2013 Mar;24(3):586-97. doi: 10.1093/annonc/mds476. Epub 2012 Nov 7. Ann Oncol. 2013. PMID: 23136229 Free PMC article. - Cancer screening trials: nuts and bolts.
Prorok PC, Marcus PM. Prorok PC, et al. Semin Oncol. 2010 Jun;37(3):216-23. doi: 10.1053/j.seminoncol.2010.05.009. Semin Oncol. 2010. PMID: 20709206 Free PMC article. - [Lung cancer screening].
Prosch H, Ebner L. Prosch H, et al. Radiologe. 2019 Jan;59(1):19-22. doi: 10.1007/s00117-018-0478-1. Radiologe. 2019. PMID: 30542924 German. - Evaluation of FTIR spectroscopy as a diagnostic tool for lung cancer using sputum.
Lewis PD, Lewis KE, Ghosal R, Bayliss S, Lloyd AJ, Wills J, Godfrey R, Kloer P, Mur LA. Lewis PD, et al. BMC Cancer. 2010 Nov 23;10:640. doi: 10.1186/1471-2407-10-640. BMC Cancer. 2010. PMID: 21092279 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical