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

Objective: Computed tomography has recently been proposed as a useful metho d for the early detection of lung cancer. In this study we compared the sta ge distribution of lung cancers detected by a computed tomographic scan wit h that of lung cancers detected by a routine chest x-ray film. Methods: Two groups of patients with biopsy-proven non-small cell lung canc er were reviewed. In the first group of 32 patients, the tumors were detect ed by a computed tomographic scan. In a second group (n = 101), the lung ca ncers were detected on routine chest x-ray films. Patients with pulmonary s ymptoms or a history of cancer were excluded. Results: There was no difference in age, sex, or cell-type distribution bet ween the 2 groups. A significantly greater number of patients undergoing a computed tomographic scan had stage IA disease compared with those having a n 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 lu ng cancers and significantly fewer cases of more advanced disease were obse rved in patients screened with computed tomography than in those having che st radiograph. These data suggest that computed tomographic screening may b e of value in improving the survival of patients with non-small cell lung c ancer.