Chest CT screening of asbestos-exposed workers: lung lesions and incidental findings

¹ The Dept of Diagnostic Radiology, Tampere University Hospital, Tampere, Finland
² Helsinki Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland
³ The Finnish Institute of Occupational Health (FIOH), Tampere, Finland, and Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland
⁴ The Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
⁵ The Dept of Cardiothoracic Surgery, Heart Center, Tampere University Hospital, Tampere, Finland
⁶ The Dept of Radiology, Turku University Hospital, Turku, Finland
⁷ The Finnish Institute of Occupational Health, Turku, Finland
⁸ The Dept of Pulmonary Diseases, Tampere University Hospital, Tampere, Finland
⁹ The Dept of Pulmonary Diseases, Turku University Hospital, Turku, Finland
¹⁰ Division of Respiratory Diseases, Dept of Medicine, Helsinki University Central Hospital Helsinki, Finland

^* To whom correspondence should be addressed. E-mail: tuula.vierikko{at}fimnet.fi.

	Abstract

The objective of this study was to determine the feasibility of chest computed tomography (CT) in screening for lung cancer among asbestos-exposed workers.

All 633 workers included in the study were examined with chest radiography and high-resolution computed tomography (HRCT). Current and ex-smokers (cessation within the past 10 years) were also screened with spiral CT (N=180). Noncalcified lung nodules were considered positive findings. The incidental CT findings not related to asbestos-exposure were registered and further examined if needed.

Noncalcified lung nodules were detected in 86 workers. Five histologically confirmed lung cancers were found. Only one of the five cancers was detected also by plain chest radiography and three were in the group with a pre-estimated lower cancer probability. Two lung cancers were stage Ia and were radically operated. Altogether 277 persons had 343 incidental findings of which 46 required further examination. Four of these were regarded as clinically important.

CT and even HRCT proved to be superior to plain radiography in detecting lung cancer in asbestos-exposed workers with many confounding chest findings. The numerous incidental findings are a major concern for future screenings, which should be considered for asbestos-exposed ex-smokers and current smokers.

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