NATIONAL LUNG SCREENING TRIAL

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。肺癌现在是女性和男性癌症死亡的最常见原因。尽管在多模式癌症治疗方面进行了大量的临床研究，但在过去的三十年中，肺癌特异性死亡率并没有显著下降。大约80%的肺癌是非小细胞组织学，其预后主要取决于诊断时的肿瘤分期。虽然非小细胞癌的总体生存率很低，但手术I期患者的10年生存率可能高达70%。这就形成了早期检测项目的基本原理。先前使用胸片和痰细胞学检查联合进行的大型筛查试验显示，在筛查的高危人群中，肺癌特异性或全因死亡率没有显著改善。然而，当代计算机断层扫描（CT）提供了在早期阶段发现肺癌的潜力，可以进行手术治疗。该项目涉及使用一项多中心、随机对照试验，对1万名肺癌高危人群进行试验，以观察低剂量螺旋CT筛查是否能降低肺癌特异性死亡率，而不是胸片。第二个目标是从特征明确的高危人群中建立标本库，用于测试未来潜在的肺癌生物分子标志物。

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. 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.