Comment on: "Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos"

Our plain-English summary of Comment on: "Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos", by F. Barbone, F. Barbiero, G. Fasola (Lung Cancer, 2019).

The study

• Authors: F. Barbone, F. Barbiero, G. Fasola
• Journal: Lung Cancer
• Published: 2019;136:150
• Type of article: Letter
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a new study. The authors responded to an article by Maisonneuve et al. on low-dose computed tomography (LDCT) screening for lung cancer in people exposed to asbestos at work. They summarized results from their own earlier publication on 10-year mortality in a cohort of 2433 asbestos-exposed men enrolled in Monfalcone, northeastern Italy. They reported a 59% reduction in lung cancer mortality in the ATOM002 cohort, which was enrolled in LDCT screening, compared with ordinary surveillance using clinical visits and chest x-rays. By smoking status, the reduction was 52% in never smokers, 71% in former smokers and 37% in current smokers. The authors noted these estimates were based on sparse data. Screening did not reduce mesothelioma mortality, while all-cause mortality was 39% lower among screened men. The letter gives no confidence intervals or case counts. The authors concluded that the estimates support an overall efficacy of LDCT screening for lung cancer in workers highly exposed to asbestos, regardless of smoking status.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on another article (Maisonneuve et al.). It summarizes results of the authors' own previously published cohort study rather than reporting a new study.
• Who was studied: In the authors' earlier study: a cohort of 2433 asbestos-exposed men enrolled in Monfalcone, northeastern Italy, followed for 10-year mortality. The ATOM002 cohort, enrolled in LDCT screening, was compared with men under ordinary surveillance.
• Exposure: Asbestos exposure, described as high and occupational. Fiber types and doses are not stated. The comparison was LDCT screening versus ordinary surveillance with clinical visits and chest x-rays.
• Main results:
  • The ATOM002 cohort, enrolled in LDCT screening, had a 59% reduction in lung cancer mortality compared with ordinary surveillance. This figure comes from the authors' earlier publication.
  • By smoking status, the reduction in lung cancer mortality among LDCT-screened men was 52% in never smokers, 71% in former smokers and 37% in current smokers.
  • LDCT screening did not reduce mortality from mesothelioma.
  • All-cause mortality was 39% lower among screened men.
  • By smoking status, the reduction in all-cause mortality was 51% among never smokers, 13% among former smokers and 33% among current smokers.
  • According to estimates by Maisonneuve et al., baseline screening in the ATOM002 cohort detected lung cancer in 0.28% of never smokers and 1.16% of ever smokers.
• The authors' conclusion: The authors concluded that, although based on sparse data, the estimates support an overall efficacy of LDCT screening for lung cancer in workers highly exposed to asbestos, independently of smoking status.
• Limitations the authors state:
  • The smoking-stratified estimates were based on sparse data.

Topics

Medical terms in this study, explained in our Lexicon: Low-Dose CT Screening, Lung Cancer.

Related studies

• Comment on: "Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos" — E.J.A. Harris, A.W. Musk, et al. (2019)
• Response to comment on: "Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos" — P. Maisonneuve, S. Iavicoli, et al. (2019)
• Impact of low-dose computed tomography screening on lung cancer mortality among asbestos-exposed workers — F. Barbone, F. Barbiero, et al. (2018)
• Low-dose computed tomography screening for lung cancer and pleural mesothelioma in an asbestos-exposed population: baseline results of a prospective, nonrandomized feasibility trial--an Alpe-adria Thoracic Oncology Multidisciplinary Group Study (ATOM 002) — G. Fasola, O. Belvedere, et al. (2007)
• Recommendations for Implementing Lung Cancer Screening with Low-Dose Computed Tomography in Europe — G. Veronesi, D.R. Baldwin, et al. (2020)
• Low-dose chest computed tomography screening of subjects exposed to asbestos — K. Kato, K. Gemba, et al. (2018)

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