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J Thorac Cardiovasc Surg 2001;121:1053-1057
© 2001 The American Association for Thoracic Surgery

General Thoracic Surgery

Detection of early-stage lung cancer: Computed tomographic scan or chest radiograph?

From the Departments of Cardiothoracic Surgery^a and Medicine,^b Weill-Cornell Medical College, New York, NY.

Received for publication May 8, 2000. Revisions requested July 21, 2000; revisions received Sept 13, 2000. Accepted for publication Oct 25, 2000. Address for reprints: Nasser Altorki, MD, Weill-Cornell Medical College, 1300 York Ave, New York, NY 10021.

Objective: Computed tomography has recently been proposed as a useful method for the early detection of lung cancer. In this study we compared the stage distribution of lung cancers detected by a computed tomographic scan with that of lung cancers detected by a routine chest x-ray film.
Methods: Two groups of patients with biopsy-proven non–small cell lung cancer were reviewed. In the first group of 32 patients, the tumors were detected by a computed tomographic scan. In a second group (n = 101), the lung cancers were detected on routine chest x-ray films. Patients with pulmonary symptoms or a history of cancer were excluded.
Results: There was no difference in age, sex, or cell-type distribution between the 2 groups. A significantly greater number of patients undergoing a computed tomographic scan had stage IA disease compared with those having an x-ray film. Of the 32 patients in the group having a scan, 10 had tumors 1 cm or less in size versus 6 of 101 in the group having a chest radiograph. Additionally, there was a significant reduction in advanced stage disease in the group having a scan.
Conclusions: In this retrospective study, a higher incidence of stage IA lung cancers and significantly fewer cases of more advanced disease were observed in patients screened with computed tomography than in those having a chest radiograph. These data suggest that computed tomographic screening may be of value in improving the survival of patients with non–small cell lung cancer.

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