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Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed
The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 ye...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340172/ https://www.ncbi.nlm.nih.gov/pubmed/37443590 http://dx.doi.org/10.3390/diagnostics13132197 |
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author | Mascalchi, Mario Picozzi, Giulia Puliti, Donella Diciotti, Stefano Deliperi, Annalisa Romei, Chiara Falaschi, Fabio Pistelli, Francesco Grazzini, Michela Vannucchi, Letizia Bisanzi, Simonetta Zappa, Marco Gorini, Giuseppe Carozzi, Francesca Maria Carrozzi, Laura Paci, Eugenio |
author_facet | Mascalchi, Mario Picozzi, Giulia Puliti, Donella Diciotti, Stefano Deliperi, Annalisa Romei, Chiara Falaschi, Fabio Pistelli, Francesco Grazzini, Michela Vannucchi, Letizia Bisanzi, Simonetta Zappa, Marco Gorini, Giuseppe Carozzi, Francesca Maria Carrozzi, Laura Paci, Eugenio |
author_sort | Mascalchi, Mario |
collection | PubMed |
description | The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers. |
format | Online Article Text |
id | pubmed-10340172 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103401722023-07-14 Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed Mascalchi, Mario Picozzi, Giulia Puliti, Donella Diciotti, Stefano Deliperi, Annalisa Romei, Chiara Falaschi, Fabio Pistelli, Francesco Grazzini, Michela Vannucchi, Letizia Bisanzi, Simonetta Zappa, Marco Gorini, Giuseppe Carozzi, Francesca Maria Carrozzi, Laura Paci, Eugenio Diagnostics (Basel) Review The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers. MDPI 2023-06-28 /pmc/articles/PMC10340172/ /pubmed/37443590 http://dx.doi.org/10.3390/diagnostics13132197 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Mascalchi, Mario Picozzi, Giulia Puliti, Donella Diciotti, Stefano Deliperi, Annalisa Romei, Chiara Falaschi, Fabio Pistelli, Francesco Grazzini, Michela Vannucchi, Letizia Bisanzi, Simonetta Zappa, Marco Gorini, Giuseppe Carozzi, Francesca Maria Carrozzi, Laura Paci, Eugenio Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title_full | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title_fullStr | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title_full_unstemmed | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title_short | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
title_sort | lung cancer screening with low-dose ct: what we have learned in two decades of italung and what is yet to be addressed |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340172/ https://www.ncbi.nlm.nih.gov/pubmed/37443590 http://dx.doi.org/10.3390/diagnostics13132197 |
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