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Fig. 1A —Risk-to-benefit ratios for study participants.
Risk-to-benefit ratio (log units) histograms for male (A) and female
(B) never-smokers, ex-smokers, and current smokers associated with four
annual screening examinations with MDCT (MD) and single-detector (SD)
(low-dose thick-collimation plus one full-dose thin-collimation package)
scanners in the Italung-CT Trial. Three different levels of expected
benefit—namely, 10%, 20%, and 30% reduction of lung cancer
mortality—are considered. Assuming 10% reduction of mortality,
risk-benefit ratio is over the unit—that is, the number of
radiation-induced deaths overcomes the estimated number of lives saved, for
male (1.13) and female (1.66) never-smokers examined with the single-detector
scanner. At the same level of screening efficacy, the ratio is between 1 and
0.1 and close to the critic value of 0.5, implying only two lives saved for
one radiation-induced death, for male (0.53) or female (0.78) never-smokers
examined with an MDCT scanner, for female former smokers examined with a
single-detector (0.87) or MDCT (0.41) scanner, and for male former smokers
examined with a single-detector scanner (0.53). Assuming 20% or 30% screening
efficacy, the ratio is around or below 0.1 for male and female current smokers
examined with either a single-detector or MDCT scanner.
