Does the early detection of lung carcinoma improve prognosis? The Turku study

Abstract

BACKGROUND. The prognosis of lung carcinoma patients is better when the diagnosis is made early, the disease is localized, and radical surgery is possible. Screening for lung carcinoma with mass radiography or sputum cytology should contribute to a more favorable prognosis. To the author's knowledge to date, large-scale screening studies have shown improved survival but no reduction in mortality. METHODS. The histologic tumor type, disease stage, treatment, and survival rates were studied in 93 men who were found to have lung carcinoma during a single chest X-ray screening of > 33,000 smoking men ages 50-69 years and in 239 men of the same age range whose lung carcinoma was detected either through symptomatic presentation or through chest X-ray obtained for other purposes. RESULTS. The histologic distribution was similar in the two groups but screening detected more early stage tumors that more often were resectable (37% vs. 19%). The 5-year survival rate for the patients detected by screening was 19% and that of the other patients was 10%, with a relative risk 0.65 (95% confidence interval, 0.50-0.84). CONCLUSIONS. The results of the current study demonstrate that chest X-ray screening might improve the prognosis of patients with lung carcinoma. However, these results are subject to many factors that were only partially controlled and should be interpreted cautiously. (C) 2000 American Cancer Society.