The MILD project:: prevention and early diagnosis of lung cancer

Lung cancer is the major cause of cancer mortality world-wide. It is estimated that in the third millenium there will be more than 1,300,000 deaths per year from lung cancer with a global 5-year survival rate of 10% in Europe and 15% in the United States. The prognosis is best if the disease is diagnosed at an early stage (stage 1) thus permitting complete surgical resection. The use of low-dose spiral computed tomography (CT) has been proposed for an early detection of the presence of pulmonary nodules in the high-risk population (mainly smokers or ex-smokers aged 50-70 years) but its real effectiveness in reducing mortality has yet to be established. In particular, the mortality from non oncologic causes linked to tobacco smoking calls for a coordinated intervention of primary and secondary prevention: it is for this reason that the Multicentric Italian Lung cancer Detection (MILD) study has been implemented, under the auspices of the National Institute for Cancer Research and Treatment of Milan, with the aim to promote smoking cessation, annual or biennial spiral CT screening and research on biological markers.