Progression of pneumoconiosis in coal miners after cessation of dust exposure: a longitudinal study based on periodic chest X-ray examinations in Hokkaido, Japan.

BACKGROUND: The progression rate of pneumoconiosis in retired coal miners over ten years has not been studied in Japan. METHODS: A retrospective longitudinal study was undertaken using chest X-rays of 1091 pneumoconiosis subjects in Hokkaido, Japan between 1985 and 2005. RESULTS: The final numbers of subjects were 207 (19% of the entry) after 1 decade and 85 (8%) after 2 decades. Sixty-two percent of 207 subjects after 1 decade and 29% of 85 showed progression in 2 decades. Thirty-one percent of ILO category 1 and 55% of category 2 subjects showed progression to complicated pneumoconiosis after 1 decade, and 6% (4 of 64) of category 1 and 6% (5 of 77) of category 2 subjects progressed to complicated pneumoconiosis during 2 decades. CONCLUSION: The progression of pneumoconiosis was observed after the cessation of dust exposure, especially during the first 10 years.

[Radiologic screening for lung cancer: present status and future perspectives]. / Radiologisches Screening des Bronchialkarzinoms: Aktueller Stand und zukünftige Perspektiven1.

Radiologic screening for lung cancer: present status and future perspectives. Lung cancer is the most common cause of death from malignancy. This is predominantly due to the poor prognosis of the mostly advanced tumor stages at the time of presentation. Prognosis of early, usually asymptomatic stages is more favourable, particularly in non-small-cell histologic types. Therefore, early detection using diagnostic tests promises reduction of mortality from lung cancer. Due to its high sensitivity for small pulmonary nodules - the most common manifestation of early lung cancer - computed tomography appears suitable as a screening test particularly as the high radiation exposure associated with standard examination protocols can be significantly reduced for this purpose. Due to the high prevalence of benign small pulmonary nodules diagnostic algorithms are required for non-invasive classification of detected nodules. Preliminary studies of low-dose CT using algorithms based on size and density of detected nodules revealed a high proportion of asymptomatic lung cancers and early resectable tumor stages with a small number of invasive procedures for benign nodules. Prior to a wide application of this technique in clinical routine more data is required as to appropriate inclusion criteria, screening intervals and most importantly the effect of screening on reduction of mortality from lung cancer.

[Lung cancer screening--what now?]. / Screening for lungekreft--hva nå?

BACKGROUND: Lung cancer is the most common cause of cancer death in developed countries. Because of the lack of efficient diagnostic tools for early detection and of efficient treatment for advanced disease, the prognosis of lung cancer is generally poor, with 10-15% surviving 5 years after diagnosis. Still, the majority of patients present with advanced disease. Stage IV disease is beyond cure and stage III disease is rarely curable with current therapies. Over the course of the last decade, rapid advances in molecular biology, pathology, bronchoscopy and radiology have provided a rational basis for earlier diagnosis and improved outcome. MATERIAL AND METHODS: This article reviews recent advances in the early detection of lung cancer by low-dose spiral CT scanning. The review is based on a literature search in Medline and data presented at the 3rd International Conference on Screening for Lung Cancer in New York in October 2000. RESULTS: The most promising advent has been the development of low-dose spiral CT as a screening tool for lung cancer. The advantage of this method is the possibility of diagnosing small peripheral tumours before they have spread to regional or distant areas. INTERPRETATION: A shift in the therapeutic paradigm from targeting clinically manifest advanced lung cancer towards asymptomatic preinvasive and early invasive cancer is occurring. If the altered stage distribution (87% stage I) as seen in three non-randomized population-based studies is real, CT screening may raise the lung cancer cure rate above 60%.

[Problems and future directions for early detection of lung cancer].

Mass screening methods for lung cancer consist of X-ray examination in men and women over 40 years of age and X-ray examination plus sputum cytology test confined to high risk groups. Examination methods which seem to be most effective for early detection at present are introduced based on the results of the examinations and treatment provided. If we are to conduct this method extensively in the future there remain many problems unsolved yet: how to systematize the execution, to contact with more examinees, to increase examination capability and effectiveness etc. Our recent directions for the nation-wide mass screening of lung cancer consist of four methods: 1. Utilization of local self-governmental mass screening. 2. Mass screening conducted by general practitioners at local clinics. 3. Active cooperation of general practitioners with local self-government. 4. Public participation in the lung project. We should continue our efforts to solve these problems.