TY - JOUR T1 - Current screening programs for lung cancer – Are inclusion criteria too rigorous to identify asymptomatic patients? JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2743 AU - Anders Bugge AU - Anne Naalsund AU - May Brit Lund Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2743.abstract N2 - Background: Preliminary results from the controlled National Lung Cancer Screening Trial (NLST) indicates a mortality reduction of > 20% in screened patients; high risk being defined as smokers (ex/current) > 55 years old with > 30 pack-years. Recent studies suggest that female smokers develop lung cancer at a younger age and following smaller amounts of tobacco consumption than males. In industrialized countries the incidence of lung cancer is falling in males, but increasing in females. We aimed to assess if the inclusion criteria used in NLST would have identified lung cancer in a cohort of asymptomatic subjects who underwent surgical resections at our tertiary university hospital.Material and methods: During the period 2002-10 clinical data from 1043 consecutive patients with lung cancer were prospectively registered. 626 patients (294 (47%) females, mean age 68 years, and 332 (53%) males, mean age 64 years), underwent surgery.Results: Of the 626 patients who underwent surgery, 267 (42%, 131 females, 136 males) had no clinical manifestations of lung disease at presentation, and chest x-rays had been performed for co-incidental conditions. In females, 30/131 (23%) were current or ex-smokers with > 30 pack-years. In males, the corresponding proportion was 65/136 (48%). Applying the NLST criteria, 77% of the females and 52% of the males would not have been admitted to the screening program.Conclusion: Less than one forth of asymptomatic females who underwent resection for lung cancer would have been included in NLST as their total consumption of tobacco in pack-years was too low. Also, half of symptom-free resected males would have been excluded from screening. ER -