Necessity of and Problems in Survival Investigation for Lung Cancer Screening -Linkage to a Cancer Registry-

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Objective. This study was designed to investigate whether the efficacy of population-based screening of lung cancer may vary according to gender and histological type. Methods. Records of lung cancer screening using chest radiography were compared to the data of the Nagasaki Cancer Registry. Sensitivity of the screening, retrospective evidence of cancers on previous radiographs, and 10-year survival rates of patients were evaluated. Results. The sensitivity and 10-year survival rates were 0.85 and 26.7% for adenocarcinoma (AD), and 0.52 and 5.0% for squamous cell carcinoma (SQ), respectively. The difference in 10-year survival rates was small between screening-detected and interval-detected patients with SQ. Most female AD patients had retrospective evidence of cancer on radiographs for 2 and 3 years before detection, and male AD patients had retrospective evidence of cancer for 1 and 2 years before detection. In contrast, most SQ cases showed no evidence of cancer on radiographs taken 1 year before detection, suggesting that SQ developed rapidly, and that AD, especially female AD, grew slowly. Ten-year survival rates of patients between the screened population and the general population of Nagasaki Prefecture were 31.8% vs. 22.3% for female non-small cell lung cancer, 16.6% vs. 13.9% for male non-small cell lung cancer patients, 36.3% vs. 24.1% for female AD patients, 22.4% vs. 14.7% for male AD patients, and 5.7% vs. 13.4% for SQ patients, respectively. Conclusions. Our findings suggest that the efficacy of radiologic screening for lung cancer may be higher in female AD patients followed by male AD patients and SQ patients. When the effectiveness of lung cancer screening is discussed based on the results from the studies of various target population, more attention should be paid to the difference in the distributions of gender and histological type.

Necessity of and Problems in Survival Investigation for Lung Cancer Screening -Linkage to a Cancer Registry-

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