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I am very much afraid that CT screenings would have the unintended consequence of actually encouraging smoking behavior if the screening test is negative.
The DANTE-Milan study was the first European randomised trial to be launched in 2001, enrolling 2472 subjects (60 74 years, ⩾20 p-y) in annual CT screenings or in observation for 4 years (Infante et al, 2008).
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In addition, CT-screening protocols have several limitations.
However, having in mind its ultimate clinical use, it was imperative that we tested this panel in small FFPE samples as these are the standard pathology specimens to be utilised in CT-screening studies.
With the relatively high cost of spiral CT, the high rate of false positives leading to unnecessary biopsy or surgery, and the need for serial measurements to confirm non-neoplastic disease, addition of an economical serum test to the CT-screening protocol could improve specificity and cost effectiveness.
For these cases, screenings using chest X-ray were ignored to evaluate low-dose CT screening.
There is a wide spectrum of low-dose CT findings in lung cancer screenings.
Tests to diagnose the cancer include screenings like MRI, CT or PET scans, an ultrasound exam and endoscopy.
As for screening rank, specificity of both low-dose CT and chest X-ray for the repeated screenings was significantly higher than that of the initial screenings.
Sensitivity of low-dose CT and chest X-ray for the repeated screenings was lower than that of the initial screenings; however, the difference was not statistically significant.
A low cost and minimally invasive serum test would be a much preferred means to complement spiral CT or potentially serve as a pre-screening method to minimise the overall costs of NSCLC detection by better selecting patients to undergo spiral CT.
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