The Evaluation of the Effectiveness of Low Dose Helical Computed Tomography Screening

Abstract

Objective. The low dose helical computed tomography (LDCT) screening for lung cancer is attracting attention because of its high detection rate, ability to detect small tumors, and high survival rate of detected cases. However, an epidemiologic study in which the endpoint is cancer mortality is necessary to evaluate the effectiveness of cancer screening because these case studies have easily contaminated biases. Method and Result. Japan Lung Cancer Screening Study (JLCSS) is a cohort study that compared the lung cancer mortality rates of CT screened group and chest X-ray screened group as an endpoint. Since 1995, 46,733 people registered in the CT screening group and 91,970 people registered in the chest X-ray screening group, and they were followed up until 2002. Conclusion. There is a problem to cancel three disadvantages such as high dose examination rate, cost and radiation exposure in addition to the results of this study for LDCT screening. The spread of the LDCT screening for lung cancer cannot be recommended until this problem is solved.