Lung Cancer Screening with Sputum Cytologic Examination, Chest Radiography, and Computed Tomography

Table 3. Case Control Studies of Lung Cancer Screening with Chest X-ray and Lung Cancer Mortality

Study, Setting, Year	Cases: Patients with Fatal Lung Cancer	Controls	Matching/Adjustment Factors	Odds Ratio for Lung Cancer Mortality Associated with Screening (95% Confidence Interval)	Study Quality
Ebeling and Nischan, Berlin, 1987⁴¹	130 men aged < 70	204 patients from community center	Age; opportunity for screening; location	0.88 (0.53-1.45)	Poor^{b c}
Ebeling and Nischan, Berlin, 1987⁴¹	130 men aged < 70	194 patients from hospital outpatient department	Age; opportunity for screening	1.09 (0.67-1.78)	Poor^{b c}
Okamoto et al, Japan, 1999⁴²	158 men and 35 women aged 40-74	579^a	National Health Insurance; smoking status; opportunity for screening; location	0.54 (0.34-0.85) < 12 mos 0.54 (0.30-0.96) < 24 mos 0.50 (0.30-1.15) 24-36 mos	Fair
Sobue, Japan, 2000⁴³	208 high-risk men, 65 low-risk women	1,269^a	National Health Insurance; smoking status; opportunity for screening; health checkups	0.72 (0.5-1.03) < 12 mos^d 0.83 (0.56-1.23) < 12-24 mos^d	Fair
Sagawa et al, Japan, 2001⁴⁴	258 smoking and nonsmoking men and 70 nonsmoking women aged > 39	1,886^a	Smoking status; opportunity for screening (all screened negative in 1989); location	0.54 (0.41-0.73) < 12 mos^d 1.24 (0.59-2.59) 12-24 mos^{d e} 0.62 (0.42-0.92) < 24 mos^d 0.64 (0.36-1.14) < 36 mos^d 2.41 (0.54-10.7) < 48 mos^d	Fair
Tsukada et al, Japan, 2001⁴⁵	149 high-risk men and 25 non-high-risk (nonsmoking) women aged > 40	801^a	National Health Insurance; smoking status; opportunity for screening	0.40 (0.27-0.59) < 12 mos^d 1.42 (0.63-3.17) < 12-24 mos^d	Fair
Nishii et al, Japan, 2001⁴⁶	412 men and women aged 40-79	3,490^a	National Health Insurance; smoking status; opportunity for screening; location	0.59 (0.46-0.74) < 12 mos^d	Fair

Notes: CXR, chest x-ray.

^a All matched by age, sex, and location.
^b Received a poor score because selection of controls was potentially biased.
^c Received a poor score for not controlling for smoking.
^d High-risk individuals were also screened with sputum cytology.
^e Excluding screening < 12 months.

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