1. The International Early Lung Cancer Action Project (I-ELCAP)
http://www.ielcap.org/
is a non-randomized prospective, single-arm study based upon the results of the Cornell University ELCAP study
http://www.ielcap.org/rp_lancet.html
in which study subjects who are at high risk for lung cancer (i.e. adult smokers and ex-smokers) will have annual LDNCSCT at one of the more than 30 participating centers in the U.S., Europe and Asia.
http://www.ielcap.org/sites.html
http://www.nyelcap.org/sites.html
All study subjects who are found to have a pulmonary nodule have management based upon a strict protocol. This is a very important feature of any screening test, because many people who have LDNCSCT will have nodules detected that are NOT lung cancer. It is important that further diagnostic and treatment steps following the detection of such a nodule does not expose the study subject to risk from inappropriate testing or surgery. The I-ELCAP protocol has been very successful in preventing unnecessary procedures.
Anyone wishing to participate in this lung cancer screening research trial can contact one of the ELCAP sites near them through the links provided at the individual center web sites, for further information about eligibility, costs and registration. A major advantage to screening at one of the I-ELCAP centers is that there is a management protocol, central data and image file management and quality control of radiologic interpretation, pathologic diagnosis and treatment.
2. People who would prefer to participate in a prospective randomized research project will soon have a trial open through the American College of Radiology Imaging Network (ACRIN). http://www.acrin.org/pdf_file2.html?file=protocol_docs/A6654.pdf
There is also a new trial sponsored by the National Cancer Institute (NCI)
http://newscenter.cancer.gov/pressreleases/lss.html
3. A third alternative is to participate in one of the many non-research based community radiographic screening programs that have opened throughout the country in the past few years. To date, there has been no publication of results of screening in these centers. There are two main types of programs. One is like the I-ELCAP and ACRIN trials and does only LDNCSCT to screen for lung cancer. The other type of program used a different technology called electron beam CT to test for both coronary artery disease as well as tumors in the chest and other parts of the body. Until there is publication of data reporting the results of management of pulmonary nodules in these programs, this author recommends participation in a research-based screening program.
If there is no availability of such screening at a reasonable distance from your home, I believe that participation in a non-research community screening program is preferable to no screening in individuals who are at high risk for lung cancer i.e. current smokers and ex-smokers who are at least 40 years of age and who have smoked a minimum of ten-pack years of cigarettes i.e. one pack per day for ten years or two packs per day for five years.