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Early Lung Cancer Action Project: overall design and findings from baseline screening

The Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low-radiation-dose computed tomography (low-dose CT) in people at high risk of lung cancer. We report the baseline experience. ELCAP has enrolled 1000 symptom-free volunteers, aged 60 years o... Full description

Journal Title: The Lancet (British edition) 1999, Vol.354 (9173), p.99-105
Main Author: Henschke, Claudia I
Other Authors: McCauley, Dorothy I , Yankelevitz, David F , Naidich, David P , McGuinness, Georgeann , Miettinen, Olli S , Libby, Daniel M , Pasmantier, Mark W , Koizumi, June , Altorki, Nasser K , Smith, James P
Format: Electronic Article Electronic Article
Language: English
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Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Early Lung Cancer Action Project: overall design and findings from baseline screening
format: Article
creator:
  • Henschke, Claudia I
  • McCauley, Dorothy I
  • Yankelevitz, David F
  • Naidich, David P
  • McGuinness, Georgeann
  • Miettinen, Olli S
  • Libby, Daniel M
  • Pasmantier, Mark W
  • Koizumi, June
  • Altorki, Nasser K
  • Smith, James P
subjects:
  • Abridged Index Medicus
  • Aged
  • Biological and medical sciences
  • CT imaging
  • Diagnosis
  • Female
  • Humans
  • Lung cancer
  • Lung Neoplasms - classification
  • Lung Neoplasms - diagnostic imaging
  • Lung Neoplasms - etiology
  • Lung Neoplasms - pathology
  • Male
  • Mass Screening
  • Medical sciences
  • Medical screening
  • Middle Aged
  • Pneumology
  • Prevalence
  • Risk Factors
  • Smoking - adverse effects
  • Tomography
  • Tomography, X-Ray Computed - methods
  • Tumors of the respiratory system and mediastinum
ispartof: The Lancet (British edition), 1999, Vol.354 (9173), p.99-105
description: The Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low-radiation-dose computed tomography (low-dose CT) in people at high risk of lung cancer. We report the baseline experience. ELCAP has enrolled 1000 symptom-free volunteers, aged 60 years or older, with at least 10 pack-years of cigarette smoking and no previous cancer, who were medically fit to undergo thoracic surgery. After a structured interview and informed consent, chest radiographs and low-dose CT were done for each participant. The diagnostic investigation of screen-detected non-calcified pulmonary nodules was guided by ELCAP recommendations, which included short-term high-resolution CT follow-up for the smallest non-calcified nodules. Non-calcified nodules were detected in 233 (23% [95% CI 21-26]) participants by low-dose CT at baseline, compared with 68 (7% [5-9]) by chest radiography. Malignant disease was detected in 27 (2·7% [1·8–3·8]) by CT and seven (0·7% [0·3–1·3]) by chest radiography, and stage I malignant disease in 23 (2·3% [1·5–3·3]) and four (0·4% [0·1–0·9]), respectively. Of the 27 CT-detected cancers, 26 were resectable. Biopsies were done on 28 of the 233 participants with non-calcified nodules; 27 had malignant non-calcified nodules and one had a benign nodule. Another three individuals underwent biopsy against the ELCAP recommendations; all had benign non-calcified nodules. No participant had thoracotomy for a benign nodule. Low-dose CT can greatly improve the likelihood of detection of small non-calcified nodules, and thus of lung cancer at an earlier and potentially more curable stage. Although false-positive CT results are common, they can be managed with little use of invasive diagnostic procedures.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionThe Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low-radiation-dose computed tomography (low-dose CT) in people at high risk of lung cancer. We report the baseline experience. ELCAP has enrolled 1000 symptom-free volunteers, aged 60 years or older, with at least 10 pack-years of cigarette smoking and no previous cancer, who were medically fit to undergo thoracic surgery. After a structured interview and informed consent, chest radiographs and low-dose CT were done for each participant. The diagnostic investigation of screen-detected non-calcified pulmonary nodules was guided by ELCAP recommendations, which included short-term high-resolution CT follow-up for the smallest non-calcified nodules. Non-calcified nodules were detected in 233 (23% [95% CI 21-26]) participants by low-dose CT at baseline, compared with 68 (7% [5-9]) by chest radiography. Malignant disease was detected in 27 (2·7% [1·8–3·8]) by CT and seven (0·7% [0·3–1·3]) by chest radiography, and stage I malignant disease in 23 (2·3% [1·5–3·3]) and four (0·4% [0·1–0·9]), respectively. Of the 27 CT-detected cancers, 26 were resectable. Biopsies were done on 28 of the 233 participants with non-calcified nodules; 27 had malignant non-calcified nodules and one had a benign nodule. Another three individuals underwent biopsy against the ELCAP recommendations; all had benign non-calcified nodules. No participant had thoracotomy for a benign nodule. Low-dose CT can greatly improve the likelihood of detection of small non-calcified nodules, and thus of lung cancer at an earlier and potentially more curable stage. Although false-positive CT results are common, they can be managed with little use of invasive diagnostic procedures.
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subjectAbridged Index Medicus ; Aged ; Biological and medical sciences ; CT imaging ; Diagnosis ; Female ; Humans ; Lung cancer ; Lung Neoplasms - classification ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - etiology ; Lung Neoplasms - pathology ; Male ; Mass Screening ; Medical sciences ; Medical screening ; Middle Aged ; Pneumology ; Prevalence ; Risk Factors ; Smoking - adverse effects ; Tomography ; Tomography, X-Ray Computed - methods ; Tumors of the respiratory system and mediastinum
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9Altorki, Nasser K
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descriptionThe Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low-radiation-dose computed tomography (low-dose CT) in people at high risk of lung cancer. We report the baseline experience. ELCAP has enrolled 1000 symptom-free volunteers, aged 60 years or older, with at least 10 pack-years of cigarette smoking and no previous cancer, who were medically fit to undergo thoracic surgery. After a structured interview and informed consent, chest radiographs and low-dose CT were done for each participant. The diagnostic investigation of screen-detected non-calcified pulmonary nodules was guided by ELCAP recommendations, which included short-term high-resolution CT follow-up for the smallest non-calcified nodules. Non-calcified nodules were detected in 233 (23% [95% CI 21-26]) participants by low-dose CT at baseline, compared with 68 (7% [5-9]) by chest radiography. Malignant disease was detected in 27 (2·7% [1·8–3·8]) by CT and seven (0·7% [0·3–1·3]) by chest radiography, and stage I malignant disease in 23 (2·3% [1·5–3·3]) and four (0·4% [0·1–0·9]), respectively. Of the 27 CT-detected cancers, 26 were resectable. Biopsies were done on 28 of the 233 participants with non-calcified nodules; 27 had malignant non-calcified nodules and one had a benign nodule. Another three individuals underwent biopsy against the ELCAP recommendations; all had benign non-calcified nodules. No participant had thoracotomy for a benign nodule. Low-dose CT can greatly improve the likelihood of detection of small non-calcified nodules, and thus of lung cancer at an earlier and potentially more curable stage. Although false-positive CT results are common, they can be managed with little use of invasive diagnostic procedures.
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18Prevalence
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abstractThe Early Lung Cancer Action Project (ELCAP) is designed to evaluate baseline and annual repeat screening by low-radiation-dose computed tomography (low-dose CT) in people at high risk of lung cancer. We report the baseline experience. ELCAP has enrolled 1000 symptom-free volunteers, aged 60 years or older, with at least 10 pack-years of cigarette smoking and no previous cancer, who were medically fit to undergo thoracic surgery. After a structured interview and informed consent, chest radiographs and low-dose CT were done for each participant. The diagnostic investigation of screen-detected non-calcified pulmonary nodules was guided by ELCAP recommendations, which included short-term high-resolution CT follow-up for the smallest non-calcified nodules. Non-calcified nodules were detected in 233 (23% [95% CI 21-26]) participants by low-dose CT at baseline, compared with 68 (7% [5-9]) by chest radiography. Malignant disease was detected in 27 (2·7% [1·8–3·8]) by CT and seven (0·7% [0·3–1·3]) by chest radiography, and stage I malignant disease in 23 (2·3% [1·5–3·3]) and four (0·4% [0·1–0·9]), respectively. Of the 27 CT-detected cancers, 26 were resectable. Biopsies were done on 28 of the 233 participants with non-calcified nodules; 27 had malignant non-calcified nodules and one had a benign nodule. Another three individuals underwent biopsy against the ELCAP recommendations; all had benign non-calcified nodules. No participant had thoracotomy for a benign nodule. Low-dose CT can greatly improve the likelihood of detection of small non-calcified nodules, and thus of lung cancer at an earlier and potentially more curable stage. Although false-positive CT results are common, they can be managed with little use of invasive diagnostic procedures.
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