Results from the first three-year follow-up of The German Lung Cancer Screening Intervention Trial (LUSI) revealed a decrease of more than 80% in the early repeat scan rates for suspicious findings with second and later low-dose multislice computed tomography (MSCT) screens. However, according to the findings there is further need of an organized screening program where the baseline scan results are available for comparison. The article with the study findings titled “Randomised study on early detection of lung cancer with MSCT in Germany: results of the first 3 years of follow-up after randomization,” is published in the current issue of the Journal of Thoracic Oncology.
Results from the US National Lung Cancer Screening Trial (NLST) revealed that screening high-risk individuals every year with low-dose computed tomography (LDCT) can reduce the mortality of lung cancer by 20% and by 7% when considering overall general mortality. Lung cancer screening trials worldwide have been showing a high number of early repeat scans for suspicious findings that are in fact false positives, leading to concerns about costs, invasive follow-up procedures, and anxiety for the screened patients.
The LUSI study is doing a comparison of no intervention in 2023 patients aged between 50 and 69 years to 5 annual screens of 2029 individuals with a history of heavy tobacco. The LUSI participants were all followed for a minimum of 3 years to up to 5 years. Basic characteristics of screening include early recall rate, detection rate, interval cancers as well of proportion of advanced cancers.
Available results revealed lower early recall rates in the subsequent screening rounds in comparison to the first round if the MSCT information from the previous screening rounds was available. Detection and biopsy rates were up to 1%, ratio of malignant to benign biopsies was 1:1.6-1:3.
The authors concluded according to a recent news release “our data indicate that the most prominent side effect “false positive alarm” cannot be controlled if the choice of doctor is at the screenee’s discretion at every annual screening visit. The early recall rates of rounds 2-4 would have been around 30%, instead of 3-4%, if the prior scans were not available. Thus, a potential lung cancer screening program must be organized such that all previous images and results are available.”