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(Chest. 2000;117:72S-79S.)
© 2000 American College of Chest Physicians

Screening for Lung Cancer Revisited and the Role of Sputum Cytology and Fluorescence Bronchoscopy in a High-Risk Group*

Timothy C. Kennedy, MD, FCCP; York Miller, MD, FCCP and Sheila Prindiville, MD

* From the University of Colorado Health Science Center, Division of Pulmonary and Critical Care Medicine, Lung Cancer Institute of Colorado, Denver, CO.

Correspondence to: Timothy C. Kennedy, MD, FCCP, 1721 East 19th Ave, #366, Denver, CO 80218

Lung cancer is an epidemic disease that is underrepresented in the research funding for early detection and chemoprevention arenas. Screening programs have been discouraged for both financial and political reasons. Yet, increasing evidence suggests that screening and early detection may improve outcome in lung cancer. Sputum cytology examination has been shown in several studies to lead to detection of lung cancer at an earlier stage, resulting in an improved 5-year survival rate. Monoclonal antibody detection, fluorescence bronchoscopy, and low-dose spiral CT increase diagnostic sensitivity and improve the ability to localize early-stage lesions. Utilizing these new techniques and improving the definition of high-risk groups may improve the success and cost-effectiveness of early detection based on sputum cytology. The ultimate goal of improving long-term survival in lung cancer will be achieved only when cancer can be detected in its early stages and lesions can be localized in large numbers. Advances in the last 15 years offer an encouraging vision for the value of early detection and effective treatment for lung cancer.

Key Words: bronchoscopy • lung cancer • monoclonal antibodies • positron emission tomography • screening • sputum cytology • survival




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