Annual Chest X-Rays Don’t Improve Lung-Cancer Mortality

Annual chest X-ray screenings have no effect on lung-cancer mortality, according to a study published online Oct. 26 in the Journal of the American Medical Association.

This major, randomized controlled trial involved 154,901 participants ages 55 to 74 from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Roughly half were assigned to annual screenings, the other half to typical care from 1993 to 2001. The researchers also analyzed data from a subset of participants who were also in the National Lung Screening Trial, which compared chest X-rays with spiral CT screening.

Participants in the intervention group were offered annual chest X-rays for four years. Follow-up of positive screening results was determined by participants and their healthcare practitioners. Participants in the usual care group were offered no interventions. The team logged cancers, deaths, and causes of death for either 13 years or until December 31, 2009, whichever came first.

The team found lung cancer rates of 20.1 per 10,000 person-years in the intervention group and 19.2 per 10,000 person-years in the usual care group. The researchers recorded 1,213 lung cancer deaths in the intervention group compared with 1,230 in usual care group through 13 years. Stage and histology were similar between the two groups. In summary, the researchers wrote, “Annual screening with chest radiograph did not reduce lung cancer mortality compared with usual care."