The PRE.DI.CA. project for radiographic lung cancer screening in cigarette smokers.

In heavy cigarette smokers and former smokers who have accumulated a high risk of lung carcinoma, a primary objective is early detection. Annual chest x-ray screening is a readily available, low cost method to detect asymptomatic lung carcinoma at an early stage (stage I) and, after radical resection, to improve the 5-year survival rate. A project of annual chest x-ray screening, named PRE.DI.CA. was started, for the early diagnosis of asymptomatic lung cancer in the high risk population of heavy cigarette smokers and former smokers, males and females, aged 45-75 years, in the province of Varese. Over a 7-year period, 4.598 heavy smokers enrolled in the PRE.DI.CA. lung project underwent 14.461 chest x-ray examinations. 45 asymptomatic lung cancers were detected and defined histologically. In the province of Varese it was possible to establish early diagnosis of lung carcinoma with annual chest x-ray screening of asymptomatic high risk smokers. 52% stage I diagnosis was achieved at the incidence screening.