Chest
Original ResearchLung Cancer5-Year Lung Cancer Screening Experience: Growth Curves of 18 Lung Cancers Compared to Histologic Type, CT Attenuation, Stage, Survival, and Size
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Study Participants
The original prospective screening trial and this study were approved by our Institutional Review Board and were compliant with the Health Insurance Portability and Accountability Act. Written informed consent had been obtained from all participants for the prospective trial, and informed consent was waived for this study.
The original study involved 1,520 participants considered to be at high risk, which was defined as a man or woman ≥ 50 years of age with a smoking history of at least 20
Growth Curve Patterns
There was a variety of growth curve appearances among the 18 lung cancers (Fig 1). A few growth curves were close to horizontal, depicting slow growth. Steeper growth curves appeared to have linear and exponential increments in volume. A few growth curves appeared to have accelerated, steeper-than-exponential growth compared with earlier growth. These curves were analyzed according to histology, CT scan attenuation, stage, survival, and initial size, and are presented in the next section.
Volume Decreases
Of the
Discussion
The lung cancers in our study had a variety of growth curves and did not uniformly demonstrate linear, exponential, or Gompertzian growth.3, 4 Gompertzian growth is exponential at an early stage and approaches a plateau as the tumor size increases.4 Most curves showed fairly steady linear or exponential increments of growth, but there also were curves that were close to horizontal and curves that showed accelerated, greater-than-exponential growth compared with earlier rates. It is possible
Acknowledgments
Author contributions: Dr. Lindell contributed to the data acquisition and analysis. Dr. Mandrekar contributed to the data analysis. All authors contributed to the preparation of the manuscript.
Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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Funding/Support: This research was supported by National Cancer Institute grant RO1CA79935-04.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).