This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. To determine if screening patients at high risk for developing lung cancer, using a low radiation dose chest CT scan, reduces the number of deaths due to lung cancer. Subjects: Men and women, age 55-74 years with a heavy smoking history equaling at least 30 pack years. Former smokers must have quit within the preceding 15 years. Patients will be randomly divided into either the experimental group or the control group. The experimental group will undergo screening with low dose chest CT scan; the control group will undergo screening with chest radiographs. Both groups will undergo testing of pulmonary function, provide samples of blood and urine at the time of enrollment, be given containers for sputum collection, complete questionnaires about family history, occupational exposure, economic status, and place of residence, and will be screened once a year for two years. Both groups will be contacted at six-month intervals to document health status and contacted once a year to complete a questionnaire about quality of life. Low-dose chest CT scan may detect a lung cancer at an early stage, allowing surgical resection and the possibility of cure. The radiation dose from a low-dose chest CT scan is less than or equal to the average annual dose from natural sources of radiation. The radiation dose for chest radiograph is much less than the average annual dose from natural sources of radiation. Risks include false positive screening CT scan requiring a full CT scan with intravenous contrast and other potentially invasive procedure (2%).
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