Düzenli AC Grafisinin Akciğer Kanseri ile İlişkisi Var Mı?


Düzenli AC. Grafisi ve Akciğer kanseri..
JAMA’da yayınlanan çalışmaya göre düzenli akciğer grafisi çektirmenin akciğer kanseri mortalitesine etkisi yok.

Original Contribution
ONLINE FIRST JAMA. Published online October 26, 2011.doi: 10.1001/jama.2011.1591

Screening by Chest Radiograph and Lung Cancer Mortality

The Prostate, Lung, Colorectal, and Ovarian (PLCO) Randomized Trial

  1. Martin M. Oken, MD;
  2. Willam G. Hocking, MD;
  3. Paul A. Kvale, MD;
  4. Gerald L. Andriole, MD;
  5. Saundra S. Buys, MD;
  6. Timothy R. Church, PhD, MS;
  7. E. David Crawford, MD;
  8. Mona N. Fouad, MD;
  9. Claudine Isaacs, MD;
  10. Douglas J. Reding, MD, MPH;
  11. Joel L. Weissfeld, MD, PhD;
  12. Lance A. Yokochi, MD, PhD;
  13. Barbara O’Brien, MPH;
  14. Lawrence R. Ragard, MD;
  15. Joshua M. Rathmell, MS;
  16. Thomas L. Riley, BS;
  17. Patrick Wright, BS;
  18. Neil Caparaso, MD;
  19. Ping Hu, PhD;
  20. Grant Izmirlian, PhD;
  21. Paul F. Pinsky, PhD;
  22. Philip C. Prorok, PhD;
  23. Barnett S. Kramer, MD, MPH;
  24. Anthony B. Miller, MD;
  25. John K. Gohagan, PhD;
  26. Christine D. Berg, MD
  27. for the PLCO Project Team

[+] Author Affiliations

  1. Author Affiliations: School of Public Health, University of Minnesota, Minneapolis (Drs Oken and Church); Marshfield Clinic Research Foundation, Marshfield, Wisconsin (Drs Hocking and Reding); Henry Ford Health System, Detroit, Michigan (Dr Kvale); Washington University, St Louis, Missouri (Dr Andriole); Huntsman Cancer Institute, University of Utah, Salt Lake City (Dr Buys); Anschutz Cancer Pavilion, University of Colorado, Denver (Dr Crawford); School of Medicine, University of Alabama at Birmingham (Dr Fouad); Lombardi Cancer Center, Georgetown University, Washington, DC (Dr Isaacs); Medical Center Cancer Pavilion, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Weissfeld); Pacific Health Research and Education Institute, Honolulu, Hawaii (Dr Yokochi); Westat Inc, Rockville, Maryland (Ms O’Brien and Dr Ragard); Information Management Services, Rockville, Maryland (Messrs Rathmell, Riley, and Wright); Division of Cancer Epidemiology and Genetics (Dr Caparaso), Biometry Research Group and Early Detection Research Group, Division of Cancer Prevention (Drs Hu, Izmirlian, Prorok, Pinsky, and Berg), and Physician Data Query Screening and Prevention Editorial Board (Dr Kramer), National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (Dr Miller); and Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland (Dr Gohagan).


Context The effect on mortality of screening for lung cancer with modern chest radiographs is unknown.

Objective To evaluate the effect on mortality of screening for lung cancer using radiographs in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

Design, Setting, and Participants Randomized controlled trial that involved 154 901 participants aged 55 through 74 years, 77 445 of whom were assigned to annual screenings and 77 456 to usual care at 1 of 10 screening centers across the United States between November 1993 and July 2001. The data from a subset of eligible participants for the National Lung Screening Trial (NLST), which compared chest radiograph with spiral computed tomographic (CT) screening, were analyzed.

Intervention Participants in the intervention group were offered annual posteroanterior view chest radiograph for 4 years. Diagnostic follow-up of positive screening results was determined by participants and their health care practitioners. Participants in the usual care group were offered no interventions and received their usual medical care. All diagnosed cancers, deaths, and causes of death were ascertained through the earlier of 13 years of follow-up or until December 31, 2009.

Main Outcome Measures Mortality from lung cancer. Secondary outcomes included lung cancer incidence, complications associated with diagnostic procedures, and all-cause mortality.

Results Screening adherence was 86.6% at baseline and 79% to 84% at years 1 through 3; the rate of screening use in the usual care group was 11%. Cumulative lung cancer incidence rates through 13 years of follow-up were 20.1 per 10 000 person-years in the intervention group and 19.2 per 10 000 person-years in the usual care group (rate ratio [RR]; 1.05, 95% CI, 0.98-1.12). A total of 1213 lung cancer deaths were observed in the intervention group compared with 1230 in usual care group through 13 years (mortality RR, 0.99; 95% CI, 0.87-1.22). Stage and histology were similar between the 2 groups. The RR of mortality for the subset of participants eligible for the NLST, over the same 6-year follow-up period, was 0.94 (95% CI, 0.81-1.10).

Conclusion Annual screening with chest radiograph did not reduce lung cancer mortality compared with usual care.

Trial Registration clinicaltrials.gov Identifier: NCT00002540

Kaynak : www.febrilnotropeni.net

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