Table 1. Controlled Trials of Lung Cancer Screening With Chest X-ray With or Without Sputum Cytology

Study, Year (Study Began) Population Intervention Prevalence
(%)		 Incident Lung Cancer (No) Advanced Tumors Stage III, IV (%) Non-resectable Tumors (%) Mortality Rate/1,000 Person-Yearsa
Northwest London Mass Radiography Service, 196035,36 Males > 40 yrs; 19% former smokers; 67% current smokers 29,723 offered CXR every 6 mos over 3 yrs; 25,300 offered CXR at baseline and at 3 yrs Intervention:
31 ( 0.10 )
Control:
20 ( 0.08 )		 Intervention:
101
Control:
76		 Intervention:
NR
Control:
NR		 Intervention:
56
Control:
71		 3 yr followup
Intervention:
0.7
Control:
0.8
Kaiser Permanente, 196433,34 10,713 members aged 35-54;
17% smokers		 Intervention: 5,156 encouraged to have annual multiphasic health checkup including CXR
Control: 5,557 usual care		 NR NR NR NR 16 yr followup
Intervention:
8.6
Usual care:
7.6
Memorial Sloan-Kettering, 197437,63-67 10,040 male smokers aged > 45 All participants: baseline CXR; 4,968 annual CXR and sputum cytology every 4 mos for 5-8 yrs; 5,072 annual CXR and screened over 5-8 yrs Dual screen:
30 (0.6)
CXR:
23 (0.46)		 Dual screen:
146
CXR:
155		 Dual screen:
64 (1.2) (incidence)
CXR:
63 (1.2) (incidence)		 Dual screen:
49
CXR:
47		 5-8 yr followup
Dual screen:
2.7
CXR:
2.7
Johns Hopkins, 197338,68-72 10,387 male smokers aged > 45 All participants: baseline CXR; 5,266 CXR and sputum cytology at baseline and every 4 mos; 5,161 annual CXR for 5-8 yrs Dual screen:
39 (0.75)
CXR:
40 (0.78)		 Dual screen:
194
CXR:
202		 NR Dual screen:
53
CXR:
56		 5-8 yr followup
Dual screen:
3.4
CXR:
3.8
Mayo Lung Project, 197139,74-76,80 10,933 male smokers aged > 45 All participants: baseline CXR, 3-day pooled sputum cytology; 4,618 to CXR and 3-day pooled sputum cytology every 4 mos for 6 yrs; 4,593 received usual care with advice for annual CXR and sputum cytology 91 (0.83) Dual screen:
206
Usual care:
160		 Dual screen:
107 (2.3)
Usual care:
109 (2.4)		 Dual screen:
32
Usual care:
19		 20 yr followup
Intervention:
4.4
Usual care:
3.9
Czech, 197540,84,85 6,345 male smokers aged 40-64 After baseline CXR: 3,171 received CXR every 6 mos over 3 yrs and 3,174 received usual care; at end of study (yrs 4-6), CXR performed annually in each group 19 (0.30) Dual screen:
108
Control:
82		 Dual screen:
53 (1.7)
Control:
46 (1.4)		 Dual screen:
77
CXR:
77		 15 yr followup:
Dual screen:
7.8
Control:
6.8
Wilde, 1972-197747 b All men in 14 districts aged 40-65 (n = 143,880) Intervention: 41,532 in 4 districts offered chest fluorography every 6 mos
Control: 102,348 in 10 districts offered chest fluorography every 12-24 mos		 Intervention:
54
Control:
68		 Intervention:
320
Control:
599		 NR Intervention:
72
Control:
81		 10 yr followup:
Intervention:
0.8
Control:
0.6

Notes: CXR, chest x-ray; NR, not reported.

a Between-group differences were not statistically significant for all studies.
b Non-randomized study.

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