Lung Cancer/Solitary Pulmonary Nodule

Risk factors
United States. Surgeon General's Advisory Committee on Smoking and Health, and United States. Public Health Service. Office of the Surgeon General. "Smoking and Health." United States. Public Health Service. Office of the Surgeon General, 1964. Official Report This landmark U.S. Surgeon General’s report added to the growing international recognition of the multiple hazards of cigarette smoking. http://profiles.nlm.nih.gov/NN/B/B/M/Q/segments.html
Tockman MS, Anthonisen NR, Wright EC, et al. Airways obstruction and the risk for lung cancer. Annals Intern Med 1987;106:512-8. This study found smokers with COPD had about a 5-fold risk of developing lung cancer compared to smokers without COPD. The more severe the COPD, the greater the risk. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3826952.

Staging

Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710-1717. The staging revisions were made to better group TNM patterns with similar prognosis and approach to treatment. Includes expected survival for clinically and surgically staged cancer at 1 through 5 years. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9187198

Silvestri G, Gould M, Margolis M, et al.  Noninvasive staging of non-small cell lung cancer.  Chest 2007;132:178S-201S.  ACCP evidence-based clinical practice guidelines (2nd Edition) reviewing the evidence for staging of non-small cell lung cancer with CT and PET scanning. http://www.ncbi.nlm.nih.gov/pubmed/17873168?ordinalpos=15&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Detterbeck F, Jantz M, Wallace M, et al.  Invasive mediastinal staging of lung cancer.  Chest 2007; 202S-220S.  ACCP evidence-based clinical practice guidelines (2nd Edition) reviewing the sensitivity and specificity of various tissue sampling  techniques:  TTNA, TBNA, EBUS, EUS, VATS, Chamberlain procedure, mediastinoscopy and extended cervical mediastinoscopy.  http://www.ncbi.nlm.nih.gov/pubmed/17873169?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

The following articles are the basis for the belief that screening with CXR and/or sputum cytology does not improve mortality. Many have expressed concern about the quality of these studies.
Fontana RS, Sanderson DR, Taylor WF, et al. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Mayo Clinic study. Am Rev Respir Dis 1984;130:561-5. Also includes a summary of the combined results of the Mayo, Sloan-Kettering, and Johns Hopkins study sites on pp 565-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6091507
Melamed MR, Flehinger BJ, Zaman MB, et al. Screening for lung cancer: results of the Memorial Sloan-Kettering study in New York. Chest 1984;86:44-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6734291

Frost JK, Ball WC, Levin ML, et al. Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am Rev Respir Dis 1984;130:549-54 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6091505

Kubik A, Parkin DM, Khlat M, et al. Lack of benefit from semi-annual screening for cancer of the lung: follow-up of a randomized controlled trial on a population of high-risk males in Czechoslavakia. Int J Cancer 1990;45:26-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2404878

The following articles address screening with chest CT scans.
The following 2 studies reached discordant conclusions about the value of CT screening.  For a nice discussion of this discrepancy, see the following editorial: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17341714&itool=pubmed_AbstractPlus

Henschke CI, Yankelevitz DF, Libby DM, et al.  Survival of patients with stage I lung cancer detected on CT screening.  N Engl J Med. 2006; 355:1763-71. Very large study (N= 31,567) found screening for lung cancer in asymptomatic at-risk patients for up to 18-months resulted in a lung cancer diagnosis in 484 participants, 412 of whom had clinical stage I disease. The researchers concluded that annual spiral CT screening in at-risk patients can detect lung cancer that is curable. http://www.ncbi.nlm.nih.gov/pubmed/17065637?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Bach PB, Jett JR, Pastorino U, et al. Computed tomography screening and lung cancer outcomes. JAMA. 2007; 297:953-61. This study pooled the results of 3 longitudinal studies of lung cancer screening with CT in asymptomatic current or former smokers (N=3,246).  The researchers concluded that screening for lung cancer with low-dose CT may increase the rate of lung cancer diagnosis and treatment, but based on models of predicted survival, it does not reduce the risk of death from lung cancer. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17341709&query_hl=14&itool=pubmed_docsum  

Solitary pulmonary nodule
Gould MK, Fletcher J, Iannettoni MD, et al.  Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition).  Chest. 2007;132(3 Suppl):108S-130S.  Guideline for how best to work up the incidental nodule(s) that nicely distills the large number of trials on this topic.
http://www.ncbi.nlm.nih.gov/pubmed/17873164?dopt=Abstract