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      Survival of patients with stage I lung cancer detected on CT screening.

      The New England journal of medicine
      Adult, Aged, Aged, 80 and over, Algorithms, Biopsy, Carcinoma, mortality, pathology, radiography, Case-Control Studies, Female, Humans, Longitudinal Studies, Lung, Lung Neoplasms, Male, Middle Aged, Neoplasm Staging, Occupational Exposure, adverse effects, Smoking, Survival Rate, Tobacco Smoke Pollution, Tomography, X-Ray Computed

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          Abstract

          The outcome among patients with clinical stage I cancer that is detected on annual screening using spiral computed tomography (CT) is unknown. In a large collaborative study, we screened 31,567 asymptomatic persons at risk for lung cancer using low-dose CT from 1993 through 2005, and from 1994 through 2005, 27,456 repeated screenings were performed 7 to 18 months after the previous screening. We estimated the 10-year lung-cancer-specific survival rate among participants with clinical stage I lung cancer that was detected on CT screening and diagnosed by biopsy, regardless of the type of treatment received, and among those who underwent surgical resection of clinical stage I cancer within 1 month. A pathology panel reviewed the surgical specimens obtained from participants who underwent resection. Screening resulted in a diagnosis of lung cancer in 484 participants. Of these participants, 412 (85%) had clinical stage I lung cancer, and the estimated 10-year survival rate was 88% in this subgroup (95% confidence interval [CI], 84 to 91). Among the 302 participants with clinical stage I cancer who underwent surgical resection within 1 month after diagnosis, the survival rate was 92% (95% CI, 88 to 95). The 8 participants with clinical stage I cancer who did not receive treatment died within 5 years after diagnosis. Annual spiral CT screening can detect lung cancer that is curable. Copyright 2006 Massachusetts Medical Society.

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