Prognosis of patients with lung cancer found in a single chest radiograph screening

Background: The prognosis of patients with lung cancer is better when the d iagnosis is made early; the disease is localized, and radical surgery is po ssible. Screening for lung cancer with mass radiography or sputum cytology should contribute to a more favorable prognosis. Large-scale screening stud ies have improved the survival rates for lung cancer but have yielded. no r eduction in mortality rates, Methods: The histologic types, stages, treatments, and survival rates were studied in 93 men who were found to have lung cancer in a single chest radi ograph screening of more than 33,000 men who smoked and were 50 to 69 years old ("screened cases"), and in 239 men of the same age range whose lung ca ncer was detected through ordinary health care system ("other cases") durin g the screening period, Results: The distribution of the histology was similar in the two groups, b ut screening detected more instances of early-stage disease that were resec table more often than in the other group (37 vs 19%), The 5-year survival r ate for men in the screened cases was 19%, and that of men in the other cas es was 10% (relative risk, 0.65; 95% confidence interval [CI], 0.50 to 0.84 ), The survival rate of men in the screened cases remained significantly hi gher than that of men in the other cases even after adjustments for age, sm oking status, histology, stage of the disease, and resectability of the dis ease (relative risk, 0.74; 95% CI, 0.55 to 1.00), Conclusions: According to this study, chest radiograph screening might impr ove the prognosis of lung cancer. Our results are, however, subject to many factors that were only partially controlled for, and they should be interp reted cautiously.