Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial. Issue 9 (4th April 2017)

• Record Type: Journal Article
• Authors: Paci, Eugenio; Puliti, Donella; Lopes Pegna, Andrea; Carrozzi, Laura; Picozzi, Giulia; Falaschi, Fabio; Pistelli, Francesco; Aquilini, Ferruccio; Ocello, Cristina; Zappa, Marco; Carozzi, Francesca M; Mascalchi, Mario
• Other Names: author non-byline.; Paci Eugenio author non-byline.; Puliti Donella author non-byline.; Zappa Marco author non-byline.; Ocello Cristina author non-byline.; Manneschi Gianfranco author non-byline.; Visioli Carmen author non-byline.; Cordopatri Giovanna author non-byline.; Giusti Francesco author non-byline.; Esposito Ida author non-byline.; Pegna Andrea Lopes author non-byline.; Bianchi Roberto author non-byline.; Ronchi Cristina author non-byline.; Carrozzi Laura author non-byline.; Aquilini Ferruccio author non-byline.; Cini Stella author non-byline.; De Santis Mariella author non-byline.; Pistelli Francesco author non-byline.; Baliva Filomena author non-byline.; Chella Antonio author non-byline.; Tavanti Laura author non-byline.; Grazzini Michela author non-byline.; Innocenti Florio author non-byline.; Natali Ilaria author non-byline.; Mascalchi Mario author non-byline.; Bartolucci Maurizio author non-byline.; Crisci Elena author non-byline.; De Francisci Agostino author non-byline.; Falchini Massimo author non-byline.; Gabbrielli Silvia author non-byline.; Roselli Giuliana author non-byline.; Masi Andrea author non-byline.; Falaschi Fabio author non-byline.; Battola Luigi author non-byline.; De Liperi Annalisa author non-byline.; Spinelli Cheti author non-byline.; Vannucchi Letizia author non-byline.; Petruzzelli Alessia author non-byline.; Gadda Davide author non-byline.; Neri Anna Talina author non-byline.; Niccolai Franco author non-byline.; Vaggelli Luca author non-byline.; Vella Alessandra author non-byline.; Carozzi Francesca Maria author non-byline.; Maddau Cristina author non-byline.; Bisanzi Simonetta author non-byline.; Picozzi Giulia author non-byline.; Janni Alberto author non-byline.; Mussi Alfredo author non-byline.; Lucchi Marco author non-byline.; Comin Camilla author non-byline.; Fontanini Gabriella author non-byline.; Tognetti Adele Renza author non-byline.; Iacuzio Laura author non-byline.; Caldarella Adele author non-byline.; Barchielli Alessandro author non-byline.; Goldoni Carlo Alberto author non-byline.;
• Is Part Of: Thorax. Volume 72:Issue 9(2017)
• Page Start: 825
• Page End: 831
• Publication Date: 2017-04-04
• Subjects: Lung Cancer -- Clinical Epidemiology; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2016-209825
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: ITALUNG is contributing to the European evaluation of low-dose CT (LDCT) screening for lung cancer (LC). Methods: Eligible subjects aged 55–69 years, smokers or ex-smokers (at least 20 pack-years in the last 10 years), were randomised to receive an annual invitation for LDCT screening for 4 years (active group) or to usual care (control group). All participants were followed up for vital status and cause of death (at the end of 2014) and LC incidence (at the end of 2013). Pathological and clinical information was collected from the Tuscan Cancer Registry data. Results: 1613 subjects were randomly assigned to the active group and 1593 to the control group. At the end of the follow-up period 67 LC cases were diagnosed in the active group and 71 in the control group (rate ratio (RR)=0.93; 95% CI 0.67 to 1.30). A greater proportion of stage I LC was observed in the active group (36% vs 11%, p<0.001). Non-significant reductions of 17% (RR=0.83; 95% CI 0.67 to 1.03) for overall mortality and 30% (RR=0.70; 95% CI 0.47 to 1.03) for LC-specific mortality were estimated. Conclusions: Despite the lack of statistical significance, the ITALUNG trial outcomes suggest that LDCT screening could reduce LC and overall mortality. Moreover, the comparison of the number of LC cases diagnosed in the two groups does not show overdiagnosis after an adequate follow-up period. A pooled analysis of all European screening trials is advocated to assess the benefit-to-harm ratio of LDCT screening and its implementation in public health settings. Trial registration number: Results, NCT02777996 .