No Lung Cancer Mortality Drop With Chest X-Ray Screening

Annual chest X-ray screening for four years does not lower lung cancer deaths versus usual care

WEDNESDAY, Oct. 26 (HealthDay News) -- Annual lung cancer screening with chest radiographs for four years does not significantly decrease lung cancer mortality compared to usual care, according to a study published online Oct. 26 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the American College of Chest Physicians, held from Oct. 22 to 26 in Honolulu.

Martin M. Oken, M.D., from the University of Minnesota in Minneapolis, and colleagues compared lung cancer mortality amongst 77,445 participants of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (aged 55 to 74 years) who were screened using annual posteroanterior view chest radiographs for four years, and 77,456 participants who received usual care between November 1993 and July 2001. Participants were followed up for either 13 years or until December 2009, to ascertain all diagnosed cancers, deaths, and causes of death.

The investigators found that the screening adherence was 11 percent in the usual care group, and 86.6 percent at baseline and 79 to 84 percent at years one through three in the intervention group. The cumulative lung cancer incidence rates per 10,000 person-years at 13 years of follow-up were 20.1 and 19.2 in the intervention and usual care groups, respectively (rate ratio [RR], 1.05; 95 percent confidence interval [CI], 0.98 to 1.12). The corresponding number of deaths was 1,213 and 1,230, respectively (mortality RR, 0.99; 95 percent CI, 0.87 to 1.22). The two groups had similar stage and histology.

"Annual screening with chest radiographs over a four-year period did not significantly decrease lung cancer mortality compared with usual care," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical industry.

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