@entity1514 computed tomography (CT) is a sensitive method for detecting early @entity2 but has a high false-positive rate and is not sensitive for detecting central preinvasive and microinvasive @entity5 . Our hypothesis was that automated quantitative image cytometry (AQC) of sputum cells as the first screening method may improve detection rate by identifying individuals at highest risk for @entity2 . A total of 561 volunteer current or former smokers 50 years of age or older, with a smoking history of more than or equal to 30 pack/years, were studied. Among these, 423 were found to have sputum atypia defined as five cells or more with abnormal DNA content using AQC. Noncalcified pulmonary nodules were found in 46% (259/561). Of the 14 detected @entity5 , 13 were detected in subjects with sputum atypia-nine by CT and four @entity5 by autofluorescence bronchoscopy. One @entity5 was detected by CT alone. AQC of sputum cells improved the detection rate of @entity2 from 1.8 to 3.1%. CT scan alone would have missed 29% of the @entity5 . This screening paradigm shift has the additional potential of reducing the number of initial CT scans by at least 25% with further savings in follow-up investigations and treatment.

XXXX screening: a different paradigm.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancers', 'cancer', 'carcinoma in situ/microinvasive cancers'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity1514 :: ('MESH:D013896', 'Disease') :: ['Thoracic']
@entity2 :: (MESH:D008175,Disease) :: ['Lung cancer']
