Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience

INTRODUCTION Lung cancer screening with low-dose computed tomography (LDCT) is one of the most promising tools for reducing mortality from lung cancer.

OBJECTIVES The aim of the study was to evaluate the results of an open-access lung cancer screening program with LDCT.

PATIENTS AND METHODS In total, 8649 asymptomatic volunteers between 50 and 75 years of age with a smoking history of at least 20 pack-years underwent LDCT screening. The presence of lung nodules with a diameter of less than 5 mm required a follow-up control visit after 12 months, and with a diameter of 5 to 10 mm—after 3, 6, and 12 months. Patients with a nodule of more than 10 mm in diameter required further diagnostic workup.

RESULTS Lung nodules were detected in 4694 individuals (54%). Lung cancer was diagnosed in 107 patients (1.24%). Of 8649 participants, 300 (3.5%) were referred for further diagnostic workup, and 125 (1.5%) underwent surgical resection (81 because of malignant lesions; 44, benign lesions). Eighty-one participants (75%) underwent surgery with a curative intent, and 26 participants underwent oncological treatment. There were no perioperative deaths. The majority of surgical patients underwent lobectomy (video-assisted, in 30 patients; and open, in 38 patients). Stage I non-small cell lung cancer was detected in 64 of the surgical patients (79%).

CONCLUSIONS The detection rate of lung cancer in the screening program with low-dose computed tomography is relatively low but patients were diagnosed at a very early stage of the disease compared with standard clinical practice.