This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Lung cancer is now the most common cause of cancer death among women and men. Despite considerable clinical research in multi-modality cancer treatment, there has been no significant decrease in lung cancer-specific mortality over the past three decades. Approximately 80% of lung cancers are of non-small cell histology, for which prognosis depends primarily upon tumor stage at the time of diagnosis. Although overall survival rates with non-small cell carcinoma are dismal, patients with surgical stage I disease may have 10 year survivals of up to 70%. This has formed the rationale for early detection programs. Previous large screening trials using combinations of chest radiographs and sputum cytology showed no signficant improvement in lung cancer-specific or all-cause mortality among screened high-risk cohorts. However, contemporary computed tomography (CT) offers the potential to detect lung cancers at early stages amenable to surgical cure. This project involves using a multicenter, randomized controlled trial of 10,000 individuals at high risk of developing lung cancer to see whether screening with low-dose helical CT can reduce lung cancer-specific mortality relative to chest radiographs. A secondary objective is to create a bank of specimens from well-characterized high-risk cohorts that can be used to test future potential biomolecular markers of lung cancer.
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