Table 3. Case Control Studies of Lung Cancer Screening with Chest X-ray and Lung Cancer Mortality
Study, Setting, Year |
Cases: Patients with Fatal Lung Cancer |
Controls |
Matching/Adjustment Factors |
Odds Ratio for Lung Cancer Mortality Associated with Screening (95% Confidence Interval) |
Study Quality |
Ebeling and Nischan, Berlin, 198741 |
130 men aged <70 |
204 patients from community center |
Age; opportunity for screening; location |
0.88 (0.53-1.45) |
Poorb c |
194 patients from hospital outpatient department |
Age; opportunity for screening |
1.09 (0.67-1.78) |
Okamoto et al, Japan, 199942 |
158 men and 35 women aged 40-74 |
579a |
National Health Insurance; smoking status; opportunity for screening; location |
0.54 (0.34-0.85) ≤12 mos
0.54 (0.30-0.96) ≤24 mos
0.50 (0.30-1.15) 24-36 mos |
Fair |
Sobue, Japan, 200043 |
208 high-risk men, 65 low-risk women |
1,269a |
National Health Insurance; smoking status; opportunity for screening; health checkups |
0.72 (0.5-1.03) ≤12 mosd
0.83 (0.56-1.23) ≤12-24 mosd |
Fair |
Sagawa et al, Japan, 200144 |
258 smoking and nonsmoking men and 70 nonsmoking women aged >39 |
1,886a |
Smoking status; opportunity for screening (all screened negative in 1989); location |
0.54 (0.41-0.73) ≤12 mosd
1.24 (0.59-2.59) 12-24 mosd e
0.62 (0.42-0.92) ≤24 mosd
0.64 (0.36-1.14) ≤36 mosd
2.41 (0.54-10.7) ≤48 mosd |
Fair |
Tsukada et al, Japan, 200145 |
149 high-risk men and 25 non-high-risk (nonsmoking) women aged >40 |
801a |
National Health Insurance; smoking status; opportunity for screening |
0.40 (0.27-0.59) ≤12 mosd
1.42 (0.63-3.17) ≤12-24 mosd |
Fair |
Nishii et al, Japan, 200146 |
412 men and women aged 40-79 |
3,490a |
National Health Insurance; smoking status; opportunity for screening; location |
0.59 (0.46-0.74) ≤12 mosd |
Fair |
Notes: CXR, chest x-ray.
a All matched by age, sex, and location.
b Received a poor score because selection of controls was potentially biased.
c Received a poor score for not controlling for smoking.
d High-risk individuals were also screened with sputum cytology.
e Excluding screening <12 months.
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