This study was designed to observe the problems in performing the screening for
early detection of lung cancer, and the degree to which regular radiographic and
cytologic screening contributes to the early detection of lung cancer in asymptomatic
volunteers. Through mass media campaign,346 male volunteers had registered to receive
radiographic and sputum cytologic screening every four months. Initial chest x-ray
examination showed 83 cases of lesions suggesting tuberculosis. Among them, two cases
were proved to be active tuberculosis. The rate of long-term folly-up over two years
was about 15%. The screening tests detected two cases of lung cancer, one prevalent
lung cancer by sputum cytologic examination, and the other by sputum cytologic
examination during follow-up. So the prevalence rate of lung cancer was 0.28% and the
incidence rate was 3.1/1,000 person-years. Both were localized lesions; ie, American Joint
Committee on Cancer (AJCC) stage Ⅰ and occult lung cancer, respectively. With these
results, we suggest that the maintenance of long term follow-up seems to be the most
important problem to evaluate the effect of early detection of lung cancer. It would
require thorough explanation of the risk of smoking in lung cancer and the wide public
education on the government's base. It should be done at several hospitals
simultaneously to include a large population in the study. Although we couldn't
determine the effect of screening for the early detection of lung cancer in this report,
new diagnostic procedure other than chest x-ray and sputum cytologic examination
would be required, according to the literature, to reduce the mortality of lung cancer by
the screening program for the early detection of lung cancer.
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