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By Andrew Buelt Questioningmedicine, intern in residency
Michael K Gould
No abstract text is available yet for this article.
November 4, 2014: Annals of Internal Medicine
Peter Mazzone, Charles A Powell, Douglas Arenberg, Peter Bach, Frank Detterbeck, Michael K Gould, Michael T Jaklitsch, James Jett, David Naidich, Anil Vachani, Renda Soylemez Wiener, Gerard Silvestri
Lung cancer screening with a low-dose chest CT scan can result in more benefit than harm when performed in settings committed to developing and maintaining high-quality programs. This project aimed to identify the components of screening that should be a part of all lung cancer screening programs. To do so, committees with expertise in lung cancer screening were assembled by the Thoracic Oncology Network of the American College of Chest Physicians (CHEST) and the Thoracic Oncology Assembly of the American Thoracic Society (ATS)...
February 2015: Chest
Steven H Woolf, Russell P Harris, Doug Campos-Outcalt
In 2013, the US Preventive Services Task Force (USPSTF) recommended low-dose computed tomographic (CT) screening for high-risk current and former smokers with a B recommendation (indicating a level of certainty that it offered moderate to substantial net benefit). Under the Affordable Care Act, the USPSTF recommendation requires commercial insurers to fully cover low-dose CT. The Centers for Medicare & Medicaid Services (CMS) is now considering whether to also offer coverage for Medicare beneficiaries. Although the National Lung Screening Trial (NLST) demonstrated the efficacy of low-dose CT, implementation of national screening may be premature...
December 2014: JAMA Internal Medicine
Barnett S Kramer, Christine D Berg, Denise R Aberle, Philip C Prorok
No abstract text is available yet for this article.
2011: Journal of Medical Screening
David F Yankelevitz, James P Smith
No abstract text is available yet for this article.
April 11, 2013: New England Journal of Medicine
Paul F Pinsky, Timothy R Church, Grant Izmirlian, Barnett S Kramer
BACKGROUND: The National Lung Screening Trial (NLST), which compared lung cancer screening with low-dose computed tomography (LDCT) versus chest radiography (CXR), demonstrated a statistically significant mortality benefit of LDCT screening. In the current study, the authors performed a post hoc analysis to examine whether the benefit was affected by various baseline factors, including age, sex, and smoking status, and whether it differed by tumor histology. METHODS: Lung cancer death rates were computed as events over person-years of observation; the mortality risk ratio (RR) was defined as the lung cancer death rate in the LDCT versus CXR trial arms...
November 15, 2013: Cancer
Denise R Aberle, Fereidoun Abtin, Kathleen Brown
The National Lung Screening Trial (NLST) has provided compelling evidence of the efficacy of lung cancer screening using low-dose helical computed tomography (LDCT) to reduce lung cancer mortality. The NLST randomized 53,454 older current or former heavy smokers to receive LDCT or chest radiography (CXR) for three annual screens. Participants were observed for a median of 6.5 years for outcomes. Vital status was available in more than 95% of participants. LDCT was positive in 24.2% of screens, compared with 6...
March 10, 2013: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Denise R Aberle, Amanda M Adams, Christine D Berg, Jonathan D Clapp, Kathy L Clingan, Ilana F Gareen, David A Lynch, Pamela M Marcus, Paul F Pinsky
BACKGROUND: The National Lung Screening Trial (NLST), a randomized study conducted at 33 US sites, is comparing lung cancer mortality among persons screened with reduced dose helical computerized tomography and among persons screened with chest radiograph. In this article, we present characteristics of the study population. METHODS: Eligible participants were aged 55-74 years and were current or former smokers with a cigarette smoking history of at least 30 pack-years...
December 1, 2010: Journal of the National Cancer Institute
Martin C Tammemagi, Stephen Lam
Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease...
May 27, 2014: BMJ: British Medical Journal
Parthiv J Mahadevia, Lee A Fleisher, Kevin D Frick, John Eng, Steven N Goodman, Neil R Powe
CONTEXT: Encouraged by direct-to-consumer marketing, smokers and their physicians are contemplating lung cancer screening with a promising but unproven imaging procedure, helical computed tomography (CT). OBJECTIVE: To estimate the potential benefits, harms, and cost-effectiveness of lung cancer screening with helical CT in various efficacy scenarios. DESIGN, SETTING, AND POPULATION: Using a computer-simulated model, we compared annual helical CT screening to no screening for hypothetical cohorts of 100 000 current, quitting, and former heavy smokers, aged 60 years, of whom 55% were men...
January 15, 2003: JAMA: the Journal of the American Medical Association
(no author information available yet)
PURPOSE: To evaluate prospectively the diagnostic performance of the New York Early Lung Cancer Action Project (NY-ELCAP) regimen in the diagnosis of early lung cancer at baseline and annual repeat computed tomographic (CT) screenings. MATERIALS AND METHODS: Informed consent and institutional review board approval were obtained for this HIPAA-compliant study of baseline and annual repeat low-dose CT screening performed with a common regimen in asymptomatic individuals at 12 institutions in New York State...
April 2007: Radiology
Bernardo H L Goulart, Mark E Bensink, David G Mummy, Scott D Ramsey
A recent randomized trial showed that low-dose CT (LDCT) screening reduces lung cancer mortality. Health care providers need an assessment of the national budget impact and cost-effectiveness of LDCT screening before this intervention is adopted in practice. Using data from the 2009 National Health Interview Survey, CMS, and the National Lung Screening Trial (NLST), the authors performed an economic analysis of LDCT screening that includes a budget impact model, an estimate of additional costs per lung cancer death avoided attributed to screening, and a literature search of cost-effectiveness analyses of LDCT screening...
February 2012: Journal of the National Comprehensive Cancer Network: JNCCN
A Seigneurin, J K Field, A Gachet, S W Duffy
BACKGROUND: Low-dose computed tomography (LDCT) screening has been shown to reduce mortality from lung cancer but at a substantial cost in diagnostic activity. The objective of this study was to investigate the characteristics of screening programmes associated with recall rates, detection rates and positive predictive values (PPVs). DESIGN: We conducted a systematic review of randomised trials and observational studies on LDCT screening for lung cancer. A meta-regression using random-effect logistic regressions was carried out to assess factors influencing recall rates for further investigation, cancer detection rates and PPVs of recall...
April 2014: Annals of Oncology: Official Journal of the European Society for Medical Oncology
(no author information available yet)
Lung cancer is the leading cause of death from cancer. It is often diagnosed at an advanced stage when curative treatment is no longer possible. Does organised screening reduce overall mortality andlor lung cancer mortality, especially in current smokers or former heavy smokers? To answer this question, we reviewed the literature using the standard Prescrire methodology. According to a meta-analysis of seven trials, and a large randomised trial (the PLCO study) involving 155 000 persons, screening the general population by means of plain chest radiography does not reduce mortality from lung cancer but carries a high risk of false-positive findings...
January 2014: Prescrire International
Pamela M McMahon, Chung Yin Kong, Colleen Bouzan, Milton C Weinstein, Lauren E Cipriano, Angela C Tramontano, Bruce E Johnson, Jane C Weeks, G Scott Gazelle
INTRODUCTION: A randomized trial has demonstrated that lung cancer screening reduces mortality. Identifying participant and program characteristics that influence the cost-effectiveness of screening will help translate trial results into benefits at the population level. METHODS: Six U.S. cohorts (men and women aged 50, 60, or 70 years) were simulated in an existing patient-level lung cancer model. Smoking histories reflected observed U.S. patterns. We simulated lifetime histories of 500,000 identical individuals per cohort in each scenario...
November 2011: Journal of Thoracic Oncology
Adriano M Priola, Sandro M Priola, Matteo Giaj-Levra, Edoardo Basso, Andrea Veltri, Cesare Fava, Luciano Cardinale
INTRODUCTION: To prospectively evaluate the frequency and spectrum of incidental findings (IF) in a 5-year lung cancer screening program with low-dose spiral computed tomography (CT) and to estimate the additional costs of their imaging workup incurred from subsequent radiologic follow-up evaluation. MATERIALS AND METHODS: A total of 519 asymptomatic volunteers were enrolled. All IFs were reported and were considered clinically relevant if they required further evaluations or with clinical implications if they required more than one additional diagnostic test for characterization or medical and/or surgical intervention...
March 2013: Clinical Lung Cancer
Maurizio Infante, 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
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...
September 1, 2009: American Journal of Respiratory and Critical Care Medicine
Stephanie A Kovalchik, Martin Tammemagi, Christine D Berg, Neil E Caporaso, Tom L Riley, Mary Korch, Gerard A Silvestri, Anil K Chaturvedi, Hormuzd A Katki
BACKGROUND: In the National Lung Screening Trial (NLST), screening with low-dose computed tomography (CT) resulted in a 20% reduction in lung-cancer mortality among participants between the ages of 55 and 74 years with a minimum of 30 pack-years of smoking and no more than 15 years since quitting. It is not known whether the benefits and potential harms of such screening vary according to lung-cancer risk. METHODS: We assessed the variation in efficacy, the number of false positive results, and the number of lung-cancer deaths prevented among 26,604 participants in the NLST who underwent low-dose CT screening, as compared with the 26,554 participants who underwent chest radiography, according to the quintile of 5-year risk of lung-cancer death (ranging from 0...
July 18, 2013: New England Journal of Medicine
Phillip M Boiselle
IMPORTANCE: Low-dose computed tomography (CT) screening was shown to reduce lung cancer-specific mortality in a large randomized trial of a high-risk population. The decision to pursue CT screening for lung cancer is a timely question raised by individuals at risk of lung cancer and by their health care practitioners. OBJECTIVES: To discuss the evidence for use of chest x-rays and low-dose CT in screening for lung cancer; to describe potential benefits, harms, and uncertainties of CT screening; and to review current guidelines for CT screening...
March 20, 2013: JAMA: the Journal of the American Medical Association
Hermine Poghosyan, Lisa Kennedy Sheldon, Mary E Cooley
BACKGROUND: Helical computed tomography (CT) has emerged as a potential screening test for lung cancer. An important component of care surrounding the use of this technology is the impact of screening on decisions surrounding smoking cessation. OBJECTIVE: The aim of this article was to conduct an integrative review of literature on the impact of lung cancer screening with CT on smoking behaviors of current smokers. METHODS: Ganong's [Res Nurs Health...
November 2012: Cancer Nursing
2014-07-13 19:18:28
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