Skip to main content

Advertisement

SpringerLink
Log in

Low-dose computed tomography for lung cancer screening: comparison of performance between annual and biennial screen

  • Chest
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the performance metrics of two different strategies of lung cancer screening by low-dose computed tomography (LDCT), namely, annual (LDCT1) or biennial (LDCT2) screen.

Methods

Recall rate, detection rate, interval cancers, sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) were compared between LDCT1 and LDCT2 arms of the MILD trial over the first seven (T0-T6; median follow-up 7.3 years) and four rounds (T0-T3; median follow-up 7.3 years), respectively.

Results

1152 LDCT1 and 1151 LDCT2 participants underwent a total of 6893 and 4715 LDCT scans, respectively. The overall recall rate was higher in LDCT2 arm (6.97 %) than in LDCT1 arm (5.81 %) (p = 0.01), which was counterbalanced by the overall lower number of LDCT scans. No difference was observed for the overall detection rate (0.56 % in both arms). The two LDCT arms had similar specificity (99.2 % in both arms), sensitivity (73.5 %, in LDCT2 vs. 68.5 % in LDCT1, p = 0.62), PPV (42.4 %, in LDCT2, vs. 40.6 %, in LDCT1, p = 0.83) and NPV (99.8 %, in LDCT2 vs. 99.7 %, in LDCT1, p = 0.71).

Conclusion

Biennial screen may save about one third of LDCT scans with similar performance indicators as compared to annual screening.

Key Points

• Biennial LDCT screening may be as efficient as the annual screening.

• Annual and biennial LDCT screening have similar frequency of interval lung cancers.

• Biennial screening may save about one third of LDCT scans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

FN:

False negative

FP:

False positive

LDCT:

Low-dose computed tomography

LDCT1:

Annual LDCT screening

LDCT2:

Biennial LDCT screening

NCNs:

Non-calcified nodules

NPV:

Negative predictive value

PPV:

Positive predictive value

TP:

True positive

TN:

True negative

References

  1. Saghir Z, Dirksen A, Ashraf H et al (2012) CT screening for lung cancer brings forward early disease. The randomised Danish Lung Cancer Screening Trial: status after five annual screening rounds with low-dose CT. Thorax 67:296–301

    Article  PubMed  Google Scholar 

  2. Pastorino U, Rossi M, Rosato V et al (2012) Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial. Eur J Cancer Prev 21:308–315

    Article  PubMed  Google Scholar 

  3. National Lung Screening Trial Research T, Aberle DR, Adams AM et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409

    Article  Google Scholar 

  4. Infante M, Cavuto S, Lutman FR, et al (2015) Long-term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography. Am J Respir Crit Care Med

  5. Heuvelmans MA, Vliegenthart R, Oudkerk M (2015) Contributions of the European trials (European randomized screening group) in computed tomography lung cancer screening. J Thorac Imaging 30:101–107

    Article  PubMed  Google Scholar 

  6. Field JK, Hansell DM, Duffy SW, Baldwin DR (2013) CT screening for lung cancer: countdown to implementation. Lancet Oncol 14:e591–e600

    Article  PubMed  Google Scholar 

  7. Moyer VA, Force USPST (2014) Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 160:330–338

    PubMed  Google Scholar 

  8. (2014) Lung‐RADS™ Version 1.0 Assessment Categories. Available via http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/LungRADS/AssessmentCategories.pdf

  9. de Koning HJ, Meza R, Plevritis SK et al (2014) Benefits and harms of computed tomography lung cancer screening strategies: a comparative modeling study for the U.S. Preventive Services Task Force. Ann Intern Med 160:311–320

    Article  PubMed  PubMed Central  Google Scholar 

  10. Marchiano A, Calabro E, Civelli E et al (2009) Pulmonary nodules: volume repeatability at multidetector CT lung cancer screening. Radiology 251:919–925

    Article  PubMed  Google Scholar 

  11. Horeweg N, Scholten ET, de Jong PA et al (2014) Detection of lung cancer through low-dose CT screening (NELSON): a prespecified analysis of screening test performance and interval cancers. Lancet Oncol 15:1342–1350

    Article  PubMed  Google Scholar 

  12. Goldstraw P, Crowley J, Chansky K et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2:706–714

    Article  PubMed  Google Scholar 

  13. Seigneurin A, Field JK, Gachet A, Duffy SW (2014) A systematic review of the characteristics associated with recall rates, detection rates and positive predictive values of computed tomography screening for lung cancer. Ann Oncol 25:781–791

    Article  CAS  PubMed  Google Scholar 

  14. National Lung Screening Trial Research T, Church TR, Black WC et al (2013) Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med 368:1980–1991

    Article  Google Scholar 

  15. Aberle DR, DeMello S, Berg CD et al (2013) Results of the two incidence screenings in the National Lung Screening Trial. N Engl J Med 369:920–931

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Becker N, Motsch E, Gross ML et al (2012) Randomized study on early detection of lung cancer with MSCT in Germany: study design and results of the first screening round. J Cancer Res Clin Oncol 138:1475–1486

    Article  CAS  PubMed  Google Scholar 

  17. Field JK, van Klaveren R, Pedersen JH et al (2013) European randomized lung cancer screening trials: Post NLST. J Surg Oncol 108:280–286

    Article  PubMed  Google Scholar 

  18. Becker N, Motsch E, Gross ML, et al. (2015) Randomised study on early detection of lung cancer with MSCT in Germany: results of the first 3 years of follow-up after randomisation. J Thorac Oncol

Download references

Acknowledgements

The scientific guarantor of this publication is Nicola Sverzellati. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work was supported by grants from the Italian Association for Research on Cancer (AIRC, IG 1227, IG 4879, special program12162), and Lombardia-Cariplo Foundation (Milan, Italy). Complex statistical methods were carried by an author (Dr Carlotta Galeone) of the present study. Institutional Review Board approval was obtained. Written informed consent was obtained by all the study participants.

Methodology: Prospective, Randomized controlled trial, Performed at one Institution.

Author information

Authors and Affiliations

  1. Radiology, Department of Surgical Sciences, University of Parma, Parma, Italy

    Nicola Sverzellati & M. Silva

  2. Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    G. Calareso & A. Marchianò

  3. Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy

    C. Galeone

  4. Department of Surgery, Section of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    S. Sestini & U. Pastorino

  5. Tumor Genomics Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    G. Sozzi

Authors
  1. Nicola Sverzellati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Calareso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Galeone
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Marchianò
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Sestini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G. Sozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. U. Pastorino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicola Sverzellati.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 23 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sverzellati, N., Silva, M., Calareso, G. et al. Low-dose computed tomography for lung cancer screening: comparison of performance between annual and biennial screen. Eur Radiol 26, 3821–3829 (2016). https://doi.org/10.1007/s00330-016-4228-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-016-4228-3

Keywords

Search

Navigation