Investigators of the COSMOS (Continuous Observation of SMOking Subjects) study show good compliance and patient survival outcomes using a 5-year low-dose computed tomography (LDCT) screening protocol in individuals at high-risk of developing lung cancer. This protocol had fewer patients requiring further diagnostic follow-up compared to other studies, including the National Lung Cancer Screening Trial (NLST), with a minimal number of incorrect diagnoses.
The 5-year survival rate for early diagnosed lung cancer is 50% but after the cancer has spread to distant regions it is only 4%. Recently, the NLST showed a 20% lung cancer mortality reduction with LDCT compared to chest x-ray, which verified that early detection can decrease lung cancer deaths. However, few studies have rigorously assessed the diagnostic performance, invasiveness and side effects of LDCT screening protocols with enduring follow-up.
The COSMOS study screened 5203 asymptomatic high-risk subjects (age ≥50 and ≥20 pack years smoking history) who, based on the study criteria, either went on to other diagnostic procedures (CT, PET, or surgery) to verify lung cancer, or were rescreened every year for the next 4 years. All subjects were clinically followed for a median of 5.2 years.
The results of this study, reported in the July issue of the Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer, show that overall, 79% of the participants remained on the study for 5 years and only 6.4% required a procedure beyond the annual LDCT. Primary lung cancer was diagnosed in 175 patients and 78% of these were diagnosed with localized disease.
Due to the size and long follow-up, there were 23,116 person-years of observation. Therefore, the overall lung cancer detection rate was 0.76 per 100 person-years. Out of the 204 invasive diagnostic procedures, 29 were benign for lung cancer, 34 had minor complications, 12 major complications and 1 post-operative fatality was reported.
There were 14 cases where the lesions were not diagnosed as cancer, but were later determined to be cancer on subsequent yearly screening. A high proportion of the cancers (87%) were treated with intent to cure and the overall 5-years survival was 78%.
“The results of the COSMOS workup protocol for indeterminate nodules detected with LDCT screening are encouraging, particularly the low recall and delayed diagnosis rates as well as the good long-term survival,” says Dr. Giulia Veronesi, lead author of the study and member of IASLC. “However, the workup can still be improved, possibly by tailoring the screening interval to the risk of the individual being screened using a risk evaluation algorithm that will hopefully also include in the near future molecular markers like a microRNA expression signature in serum.”
Dr. Giulia Veronesi from the Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy is a member of IASLC.
About the IASLC:
The International Association for the Study of Lung Cancer (IASLC) is the only global organization dedicated to the study of lung cancer. Founded in 1974, the association’s membership includes more than 4,000 lung cancer specialists in 80 countries. To learn more about IASLC please visit www.iaslc.org
Rob Mansheim | Eurek Alert!
Experimental MERS vaccine shows promise in animal studies
29.07.2015 | NIH/National Institute of Allergy and Infectious Diseases
It don't mean a thing if the brain ain't got that swing
28.07.2015 | University of California - Berkeley
Researchers have developed an ultrafast light-emitting device that can flip on and off 90 billion times a second and could form the basis of optical computing.
Joint BioEnergy Institute study identifies bacterial protein that is key to protecting rice against bacterial blight
A bacterial signal that when recognized by rice plants enables the plants to resist a devastating blight disease has been identified by a multi-national team...
Researchers in the Cockrell School of Engineering at The University of Texas at Austin are one step closer to delivering smart windows with a new level of energy efficiency, engineering materials that allow windows to reveal light without transferring heat and, conversely, to block light while allowing heat transmission, as described in two new research papers.
By allowing indoor occupants to more precisely control the energy and sunlight passing through a window, the new materials could significantly reduce costs for...
Argonne scientists used Mira to identify and improve a new mechanism for eliminating friction, which fed into the development of a hybrid material that exhibited superlubricity at the macroscale for the first time. Argonne Leadership Computing Facility (ALCF) researchers helped enable the groundbreaking simulations by overcoming a performance bottleneck that doubled the speed of the team's code.
While reviewing the simulation results of a promising new lubricant material, Argonne researcher Sanket Deshmukh stumbled upon a phenomenon that had never been...
A NASA camera on the Deep Space Climate Observatory (DSCOVR) satellite has returned its first view of the entire sunlit side of Earth from one million miles away.
The color images of Earth from NASA's Earth Polychromatic Imaging Camera (EPIC) are generated by combining three separate images to create a...
23.07.2015 | Event News
10.07.2015 | Event News
25.06.2015 | Event News
29.07.2015 | Physics and Astronomy
29.07.2015 | Life Sciences
29.07.2015 | Awards Funding