Is Biennial Lung Cancer Screening Safe and Effective?
Posted: Monday, August 12, 2019
According to the 10-year results of the Multicentric Italian Lung Detection (MILD) trial, the benefit of biennial lung cancer screening is similar to that of annual lung screening, in terms of mortality reduction. Ugo Pastorino, MD, of the Fondazione IRCCS Istituto Nazionale Dei Tumori, Italy, and colleagues, published their study results in the European Journal of Cancer.
“The MILD trial provides original evidence that prolonged screening beyond 5 years with biennial [low-dose computed tomography] can achieve [a lung cancer] mortality reduction comparable to annual [low-dose computed tomography], in subjects with a negative baseline examination,” the investigators concluded.
In this trial, the detection and mortality rates of 2,376 patients, randomly assigned to annual or biennial screening, were analyzed over 10 years. All patients were current or former smokers for a minimum of 20 pack-years, and at least 50 years of age, with an adequate performance status and no history of cancer within 5 years. Primary prevention and pulmonary function test evaluations were also implemented during the course of the study.
The overall 10-year and lung cancer mortality rates did not significantly differ between the annual and biennial screening groups. The frequency of lung cancer detection also was not significantly different between the two groups, with 58 and 40 patients in the annual and biennial groups, respectively. However, the prevalence of stage 2 to stage 4 lung cancer was significantly higher in the annual screening group than in the biennial screening group (27 vs. 22 patients), as were resection rates (74% vs. 53%, P = .0004).
For the 1,974 patients with negative baseline scans, the biennial screening interval resulted in a 37% reduction in the total number of scans completed, without detrimental survival effects. The authors noted that further validation of these findings in a larger, randomized trial is warranted.
Disclosure: The study authors reported no conflicts of interest.