Low-dose spiral computer tomography screening for lung cancer [Article@Attualità sullo screening del tumore polmonare con tomografia computerizzata spirale a bassa dose]

Lung cancer screening is useful for many reasons: first, lung cancer is the main cause of cancer deaths in both men and women; second, global 5-year survival rates have remained unchanged at around 10-15% despite advances in medical and surgical treatment. The mainstay of therapy is surgery. Satisfactory outcome is achieved with radical removal of a tumor detected at an early stage of disease. This is the simple rationale behind the development of an instrument that enables early diagnosis of lung cancer while still at the preclinical stage, thus providing the surgeon with a better chance of successful treatment. Recently developed low-dose computed tomography (CT) programs have pioneered in obtaining large amounts of information about tumor size, distribution and evolution. Although performed on limited samples, the programs have contributed to the evaluation of screening feasibility in nonrandomized and non-controlled trials, offering opportunities for testing and developing optimal time periods between control visits, validating diagnostic algorithms with various adjuvant methods and treatment options in the management of early stage tumors. The potential benefit to be gained from this imaging procedure needs to be weighed against acceptable economic costs and radiation-induced tissue damage. Reliable data from controlled randomized trials currently under way in many countries will not be expected for several years.