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Screening for lung cancer: The Mayo lung project revisited
Author(s) -
Flehinger Betty J.,
Kimmel Marek,
Polyak Tatyana,
Melamed Myron R.
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930901)72:5<1573::aid-cncr2820720514>3.0.co;2-9
Subject(s) - medicine , lung cancer screening , lung cancer , population , stage (stratigraphy) , cancer , incidence (geometry) , sputum , lung , natural history , surgery , demography , tuberculosis , environmental health , pathology , paleontology , physics , sociology , biology , optics
Background . The Mayo Lung Project (MLP) reported lung cancer incidence and mortality in a population offered chest radiographs and sputum cytologic screening examinations every 4 months and a population offered only the Mayo Clinic advice to undergo annual examination. No mortality benefit attributable to screening was observed after 6 years of observation and at least 1 year of follow‐up. Methods . The authors describe a simulation study designed to estimate from Mayo data the parameters in a mathematical model of the natural history of lung cancer and to estimate the potential benefit associated with periodic screening of high‐risk people starting at 45 years of age. Results . It was found that the mean duration of Stage non–small cell lung cancer is at least 4 years and that rates of Stage I detectability and curability are less than 25% and 35%, respectively. Conclusions . A trial of the magnitude, duration, and contamination of the MLP would have a less than 20% probability of showing significant benefit from screening; however, long‐term annual screening might result in a modest decrease in lung cancer mortality, ranging from 0% to 13%. A greater benefit would accrue from improved detection and treatment.