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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Lung cancer &#40;LC&#41; is the leading cause of cancer death&#58; prevalence is low&#44; but diagnosis is usually made in advanced stages&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> conferring a very low overall 5-year survival rate &#40;6&#37;&#8211;18&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> In Europe&#44; about 400&#44;000 LC cases are diagnosed&#44; 300&#44;000 deaths occur annually&#44; and the 5-year average survival rate is 12&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> In Spain&#44; LC is the third most common tumor&#44;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4&#44;5</span></a> and about 29&#44;000 new cases are diagnosed every year&#46; Smoking is the most important etiopathogenic factor &#40;70&#37; of cases&#41;&#44; so campaigns to prevent people from starting and to help smokers quit&#44; together with the introduction of early detection measures&#44; can reduce LC morbidity rates&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The main objective of cancer screening programs is to diagnose cancer in early stages when it is still curable&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> Several publications have shown that 85&#37; of cases of early-stage LC can be detected with low-dose computed tomography &#40;LDCT&#41;&#44; and the 10-year survival rate in stage I disease is as high as 88&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Several LDCT screening programs have demonstrated their usefulness in at-risk populations&#46; The National Lung Screening Trial &#40;NLST&#41; showed a 20&#37; reduction in mortality compared to chest X-ray screening after a mean follow-up of 6&#46;5 years&#44; and this approach now has a grade B recommendation from the US Preventive Services Task Force &#40;USPSTF&#41; in smokers of &#8805;20 pack-years aged 50&#8211;80 years or former smokers of &#60;15 pack-years&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2015&#44; the European Respiratory Society &#40;ERS&#41; and the European Society of Radiology &#40;ESR&#41; recommended screening for LC with LDCT<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> in comprehensive&#44; quality-assured programs within a clinical trial or in a care setting in medical centers with multidisciplinary teams that meet minimum requirements&#46; Initiatives calling for screening have emerged in Spain&#44; but this strategy is not included in the national cancer program of the Ministry of Health&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In Europe&#44; several projects are underway&#44;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">14&#44;15</span></a> such as the Multicenter Italian Lung Detection &#40;MILD&#41; and NEderlands-Leuvens Longkanker Screenings ONderzoek &#40;NELSON&#41; randomized trials&#46; These studies use less restrictive inclusion criteria than NLST&#44; and have reported a 24&#37; reduction in LC mortality in men&#44; and an even greater reduction &#40;33&#37;&#8211;59&#37;&#41; in women&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> while 50&#37; of cancers detected with LDCT were stage I&#44; compared with 75&#37; at advanced stages in the control group&#46; However&#44; the European Network of Health Technology Assessment Agencies &#40;EUnetHTA&#41; does not recommend this strategy&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Our main objective is to analyze the survival and mortality of LC diagnosed by screening with LDCT in Spain&#39;s largest screening program&#46; The secondary objective was to describe the characteristics of our study population and diagnosed LCs&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">Between June 2008 and November 2020&#44; taking advantage of an opportunistic screening unit based in our institution&#44; we contacted possible candidates by telephone and recruited 8546 asymptomatic volunteers to our study&#46; Inclusion criteria from 2008 to 2016 were &#8805;50 years&#44; smoker &#8805;10 pack-years&#46; After 2016 we included smokers &#8805;15 pack-years&#44; and former smokers &#60;15 years smoke-free&#44; with no personal history of cancer&#44; except for basal cell carcinoma of the skin&#46; Informed consent approved by the Ethics Committee of our hospital was collected from all participants&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">After epidemiological data and risk factors were collected&#44; 8278 volunteers were selected&#46; They performed a baseline LDCT and at least one more for annual monitoring&#46; Negative cases continued with a third annual follow-up scan and subsequently every 18 months until 72 months&#46; The International Early Lung Cancer Action Program &#40;I-ELCAP&#41;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> was used for diagnosis and follow-up of findings &#40;see <a href="http://www.ielcap.org/protocols">www&#46;ielcap&#46;org&#47;protocols</a>&#41;&#44; with a retrospective analysis of the data collected in this cohort&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Between 2008 and 2016&#44; the baseline study was considered positive if solid or partially solid non-calcified nodules &#40;NCN&#41; &#8805;5<span class="elsevierStyleHsp" style=""></span>mm or non-solid nodules &#8805;8<span class="elsevierStyleHsp" style=""></span>mm were observed&#46; Subsequently&#44; nodules &#8805;6<span class="elsevierStyleHsp" style=""></span>mm were considered positive&#44; in line with changes made in the I-ELCAP protocol&#46; If positive&#44; patients were followed up with LDCT at 3 months&#44; positron emission tomography-computed tomography &#40;PET-CT&#41; or biopsy&#44; according to size or criteria highly suggestive of malignancy&#46; If infection was suspected&#44; antibiotic treatment and monthly LDCT follow-up were recommended&#46; If a partial or complete resolution was demonstrated&#44; the next follow-up was performed after 1 year&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Pre-existing tumors were defined as nodules detected in the baseline study and emerging tumors were those that appeared <span class="elsevierStyleItalic">de novo</span> during LDCT follow-up and were diagnosed as cancer&#46; Findings during screening prompting a diagnostic procedure&#44; such as biopsy&#44; surgery&#44; bronchoscopy&#44; or PET&#44; that yielded a benign result were considered false positives&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Chronic obstructive pulmonary disease &#40;COPD&#41; was classified by spirometry as mild &#40;forced expiratory volume in 1 second &#91;FEV1&#93; &#8805;80&#37; predicted&#41;&#44; moderate &#40;50&#37;<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>FEV1<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>80&#37;&#41;&#44; severe &#40;30&#37;<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>FEV1<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;&#44; and very severe &#40;FEV1<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>30&#37;&#41;&#44; according to Global Initiative for Chronic Obstructive Lung Disease criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> Patients diagnosed with LC were stratified according to the 8th TNM international classification&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> with an expected follow-up of 10 years&#46; Emphysema was graded following the CT imaging criteria defined by the I-ELCAP protocol&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Data on LC mortality were collected from the patient&#39;s medical history and the causes of overall mortality from the electronic medical record updated in November 2020 &#8211; overall mortality being defined as deaths from LC plus deaths from other causes such as cancers other than LC&#44; vascular accidents&#44; sepsis&#44; <span class="elsevierStyleItalic">etc&#46;</span> The overall mortality rate was calculated by dividing all deaths by the sum of disease-free months&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">For statistical analysis&#44; we used the R program &#40;version 3&#46;6&#46;3&#41; and RStudio &#40;version 1&#46;2&#46;5033&#41; as well as the SPSS Statistics version 26 &#40;IBM Corp&#46;&#44; Armonk&#44; NY&#41;&#44; with a <span class="elsevierStyleItalic">p</span> value of &#60;0&#46;05 being considered significant&#46; For continuous variables with normal distribution&#44; we calculated the mean&#44; median and range&#44; and variables without normal distribution were analyzed using a Wilcoxon signed-rank test&#46; For categorical variables&#44; we collected the relative frequency distribution and used the contingency table analysis with Fisher&#39;s test or <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#46; Calculations of pre-existing and emerging tumors were performed according to the diagnostic round&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">For risk calculations&#44; we performed a bivariate logistic regression that included the variables age&#44; sex&#44; family history&#44; body mass index &#40;BMI&#41;&#44; pack-years&#44; COPD&#44; and emphysema&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Using mortality data&#44; we described 5- and 10-year survival of LC patients using Kaplan&#8211;Meier curves and we used the Cox method of proportional risks to calculate risk of death using the variables age&#44; sex&#44; surgical treatment&#44; and stages&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0080" class="elsevierStylePara elsevierViewall">Study patient characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Of the 8546 volunteers included&#44; 8278 underwent at least 2 LDCTs&#44; except those who were diagnosed with LC in the baseline study who had only 1 follow-up test &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In total&#44; 62&#46;8&#37; were men and 37&#46;2&#37; were women&#46; The overall adherence rate was 96&#46;84&#37;&#44; with a median follow-up of 72 months &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67&#46;6&#44; standard deviation &#91;SD&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#46;03&#41;&#46; The mean number of LDCTs performed during the study period was 6 &#40;1&#8211;15&#41; per person&#44; 15&#46;4&#37; of whom had emphysema in the baseline LDCT&#46; FEV1&#47;forced vital capacity &#40;FVC&#41; for the assessment of airway obstruction was only collected in 3387 individuals&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 239 tumors were diagnosed in 223 people&#44; with 2 patients presenting 3 tumors and 12 presenting 2 tumors&#46; In all&#44; 124 tumors were pre-existing &#40;ratio by sex<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;5&#37;&#41;&#44; while 115 were emerging &#40;ratio by sex<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;4&#37;&#41;&#59; no significant differences in diagnosis by sex were detected for either category &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;131&#41;&#46; Among patients with multiple tumors&#44; 12 were metachronous and 3 were synchronous&#59; of these&#44; one refused surgery and the other 2 were not treated surgically&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In total&#44; 113 patients &#40;1&#46;35&#37;&#41; were false positives&#44; whether at baseline or in the follow-up LDCTs&#44; determined as follows&#58; 43 punctures&#44; not performed in 10 cases due to resolution of the lung lesion or refusal by the patient&#59; 10 bronchoscopies&#59; 37 PETs&#59; and 23 surgical biopsies with a benign result&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Cases diagnosed as LC comprised significantly more smokers &#40;&#62;13 pack-years&#41; than the rest of the study population &#40;43&#46;75 <span class="elsevierStyleItalic">vs&#46;</span> 30&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; older patients &#40;59 <span class="elsevierStyleItalic">vs&#46;</span> 56 years&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and patients with more severe COPD &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#44; while there were no differences in BMI &#40;26&#46;55 <span class="elsevierStyleItalic">vs&#46;</span> 26&#46;70&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;1919&#41;&#46; Only the variables age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; pack-years &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; and BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; were statistically significant in a logistic regression analysis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The predominant histological type was adenocarcinoma &#40;75&#46;3&#37;&#41;&#44; of which 21 cases were minimally invasive and 10 <span class="elsevierStyleItalic">in situ</span>&#44; followed by squamous &#40;11&#46;3&#37;&#41; and neuroendocrine disease &#40;11&#46;3&#37;&#41;&#44; of which 8 were carcinoid tumors and 18 were small-cell neuroendocrine tumors&#46; A total of 76&#46;6&#37; were early stage &#40;I and II&#41;&#44; while 4&#46;2&#37; were in stage IV&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The annual rate of emerging disease was 0&#46;17 and the number of participants needed to detect an LC in one year was 416&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The total percentage of deaths was 1&#46;4&#37;&#44; of which 0&#46;5&#37; were deaths from LC and 0&#46;9&#37; from other causes&#46; Our overall mortality rate was 1&#46;99 per 1000&#46; The specific LC mortality rate was 16&#46;6&#37; &#40;37 people&#41;&#44; of which 4 were in stage I &#40;1&#46;83&#37;&#41;&#44; 3 in stage II &#40;1&#46;38&#37;&#41;&#44; 25 in stage III &#40;1&#46;46&#37;&#41;&#44; and 5 in stage IV &#40;2&#46;29&#37;&#41;&#46; Most deaths were due to disease progression &#40;34 cases&#41; or respiratory complications &#40;3 cases&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Women had a lower relative risk &#40;RR&#41; of death at 5 years &#40;RR women<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;73 <span class="elsevierStyleItalic">vs&#46;</span> RR men<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;37&#41;&#44; but the differences were not significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;1711&#44; confidence interval &#91;CI&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;47&#8211;1&#46;15&#41;&#46; In contrast&#44; the variables age &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;95&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;95&#8211;0&#46;96&#41;&#44; pack-years &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;01&#44; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;01&#8211;1&#46;02&#41;&#44; and surgical treatment &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;75&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;57&#8211;0&#46;99&#41; showed statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; In this series&#44; 44 patients with tumors did not undergo surgery &#40;12 stages I&#8211;II and 32 stages III&#8211;IV&#41;&#44; with 5- and 10-year survival rates of 70&#46;7&#37; and 40&#46;5&#37;&#44; significantly lower than tumors that were operated on &#40;94&#37; and 87&#46;9&#37;&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Five-year overall survival was 86&#37; &#40;CI&#58; 81&#46;4&#8211;90&#46;8&#41; and 10-year overall survival was 72&#46;2&#37; &#40;CI&#58; 65&#46;6&#8211;79&#46;4&#41;&#44; with a median of 91 months &#40;mean 89&#59; range<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#8211;150&#44; CI&#58; 83&#46;64&#8211;94&#46;75&#41;&#44; while for stages I&#8211;II median survival was 98&#46;5 months and 61 months for stages III&#8211;IV &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Overall 5-year LC survival &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41; was 90&#37; &#40;CI&#58; 86&#8211;94&#46;1&#41; and 10-year LC survival was 80&#46;1&#37; &#40;CI&#58; 74&#46;1&#8211;86&#46;5&#41;&#44; while 5- and 10-year survival for stage I disease was 98&#46;5&#37; &#40;CI&#58; 96&#46;6&#8211;100&#41; and 97&#46;4&#37; &#40;CI&#58; 94&#46;5&#8211;100&#41;&#44; respectively&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Our results are comparable with published evidence in terms of pre-existing and emerging LC&#44; histology&#44; and staging&#46; In the baseline round&#44; the rate of pre-existing LC in our series was 1&#46;5&#37;&#44; similar to ITALUNG&#44; and slightly higher than NELSON &#40;0&#46;9&#37;&#41; and the Pamplona International Early Lung Cancer Detection Program &#40;P-IELCAP&#41; &#40;1&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> but lower than the UK Lung Cancer Screening Trial &#40;UKLS&#41; &#40;2&#46;1&#37;&#41;&#46; This article reports the experience of the largest LDCT screening program in LC with the second-longest follow-up in Spain&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In 2000&#44; the Cl&#237;nica Universitaria de Navarra joined the I-ELCAP&#44; and reported a yield similar to other European programs&#44; with a rate of stage I LC diagnoses of 85&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> In June 2008&#44; our hospital also joined the project&#44; reporting 52&#46;08&#37; stage I tumors&#44; a preliminary 5-year overall survival of 58&#46;5&#37; and specific LC survival of 67&#46;1&#37;&#44; with a rate of 75&#46;8&#37; for surgical cases&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> The proportion of emerging tumors in our series was 1&#46;4&#37;&#44; the same as in P-IELCAP and similar to NLST &#40;1&#46;5&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; Our 10-year LC survival rate for stage I disease was 97&#37;&#46; This improved outcome may be explained by the greater number of controls&#44; since the inclusion criteria and diagnostic algorithms are very similar&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> with surgical resecability rates similar to other series&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> Our low false positive rate of 1&#46;36&#37; is comparable only to the 1&#46;2&#37; reported by the NELSON study&#44; which used stricter volumetric criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> All other programs show higher rates&#44; ranging from 5&#46;2&#37; in the Danish Lung Cancer Screening Trial &#40;DLCST&#41; to 24&#46;2&#37; in the NLST&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a></p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Adenocarcinoma was the most frequent histological type&#44; with no sex differences&#44; similar to other screening programs&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;25</span></a> Overall&#44; 61&#46;3&#37; of our LC cases were stage I&#44; lower than P-IELCAP &#40;85&#37;&#41; and the Lung Cancer Screening Intervention &#40;LUSI&#41; &#40;82&#37;&#41;&#44; but similar to NELSON &#40;64&#37;&#41; and slightly better than NLST&#44; which reported a total of 39&#46;6&#37; stage I cases&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> and MILD&#44; which had a total of 50&#37; in stage I&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Our 10-year survival rate for stage I disease of 97&#46;5&#37; is higher than that of P-IELCAP &#40;80&#37;&#41; and I-ELCAP &#40;88&#37;&#41;&#46; This is probably due to the low rate of minimally invasive adenocarcinomas &#40;8&#46;8&#37;&#41;&#44; adenocarcinoma <span class="elsevierStyleItalic">in situ</span> &#40;4&#46;2&#37;&#41;&#44; and carcinoid tumors &#40;3&#46;3&#37;&#41; in our series&#46; The rate of advanced stage disease was low&#44; with 8&#37; of emerging tumors and 2&#37; of those pre-existing tumors in stage IV&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This paper underlines the significance of both COPD and emphysema detected on CT as risk factors for LC&#46; These importance of these parameters in the selection of volunteers has already been demonstrated in the literature&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> since the greater the severity of centrilobular emphysema&#44; the greater the risk of LC&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> The same premise applies to the pack-year index&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Age is the independent variable taken into account in all screening programs&#46; Inclusion criteria range between 50 and 80 years&#44; since beyond this limit the risk of comorbidities due to overdiagnosis and inefficiency increases&#46; In our series&#44; we included people aged 50&#8211;80 years &#40;with the exception of 12 individuals under 50 years&#41; with the highest inclusion peak occurring in the 50 to 60-year range &#40;74&#46;12&#37;&#41;&#46; The peak range for LC was from 60 to 65 years&#44; very similar to that of other publications&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">The specific LC mortality rate at 12 years of follow-up was 16&#46;6&#37;&#44; slightly lower than in NELSON&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> possibly because our screening program had a longer overall follow-up combined with shorter visit intervals&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Our population showed a high adherence rate of 96&#46;8&#37;&#44; higher than NELSON &#40;90&#37;&#41;&#44; and significantly higher than the 56&#37; adherence rate reported by P-IELCAP&#46; This lower rate in the P-IELCAP study was probably due to different health coverage conditions&#58; under an agreement with the Spanish National Health Service&#44; the services offered by our Foundation are fully subsidized&#46; Improving adherence is a multifactorial problem requiring multiple strategies&#44; including the contribution of the nursing staff&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Evidence has shown that female sex is gaining more specific weight&#44; with an increase in mortality rates of 6&#46;5&#37; in the last 5 years&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a> In our series&#44; women accounted for 37&#46;32&#37; of the overall cohort and 28&#46;03&#37; of LC diagnoses&#59; specific mortality among individuals diagnosed with LC was 19&#46;4&#37;&#44; with no significant differences from men &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;46&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our study has certain limitations&#46; Firstly&#44; it is a single-center screening trial with a single study group that is not completely comparable to the aforementioned randomized trials&#46; Secondly&#44; we recruited younger participants with a lower smoking history threshold than those used in other studies&#46; Generally&#44; screening programs base their selection on smoking habit&#44; with some uniformity in the pack-year index&#44; with variations of &#62;15 pack-years in NELSON<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> and &#62;30 pack-years in NLST&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a> Our study&#44; that began in 2008 with limited evidence&#44; included smokers &#60;15 pack-years&#44; but in combination with other conditions&#44; such as family history of LC&#44; occupational exposure&#44; previous respiratory diseases&#44; genetic predisposition or socioeconomic status&#44; since these factors significantly increase the risk of LC&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;27&#44;29</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Thirdly&#44; we cannot rule out the existence of selection bias and&#44; in particular&#44; a healthy volunteer effect&#46; This was described in P-IELCAP&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> in which the mildest COPD cases were the ones with the best adherence&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In conclusion&#44; our results are comparable with published evidence in terms of pre-existing and emerging LC&#44; histology&#44; and stage&#46; LC-specific survival and mortality is improved with LDCT screening when performed by multidisciplinary teams with experience in the diagnosis and management of LC&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0185" class="elsevierStylePara elsevierViewall">This paper has not received any funding&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interests</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors state that they have no conflict of interests&#46;</p></span></span>"
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    "fechaRecibido" => "2021-07-08"
    "fechaAceptado" => "2021-10-26"
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            0 => "Lung cancer"
            1 => "Lung cancer screening"
            2 => "Early detection"
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          "palabras" => array:3 [
            0 => "C&#225;ncer de pulm&#243;n"
            1 => "Detecci&#243;n del c&#225;ncer de pulm&#243;n"
            2 => "Detecci&#243;n precoz"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Lung cancer &#40;LC&#41; is usually diagnosed at advanced stages with only a 12&#37; 5-year survival&#46; Trials as NLST and NELSON show a mortality decrease&#44; which justifies implementation of lung cancer screening in risk population&#46; Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography &#40;LDCT&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical records from International Early Lung Cancer Detection Program &#40;IELCAP&#41; at Valencia&#44; Spain were analyzed&#46; This program recruited volunteers&#44; ever-smokers aged 40&#8211;80 years&#44; since 2008&#46; Results are compared to those from other similar sizeable programs&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 8278 participants were screened with at least two-rounds until November 2020&#46; A mean of 6 annual screening rounds were performed&#46; We detected 239 tumors along 12-year follow-up&#46; Adenocarcinoma was the most common histology&#44; being 61&#46;3&#37; at stage I&#46; The lung cancer prevalence and incidence proportion was 1&#46;5&#37; and 1&#46;4&#37;&#44; respectively with an annual detection rate of 0&#46;17&#46; One-year survival and 10-year survival were 90&#37; and 80&#46;1&#37;&#44; respectively&#46; Adherence was 96&#46;84&#37;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC&#44; and is comparable to similar screening programs&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n y objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El c&#225;ncer de pulm&#243;n &#40;CP&#41; se diagnostica habitualmente en estadios avanzados con una supervivencia media a cinco a&#241;os del 12&#37;&#46; Ensayos como el <span class="elsevierStyleItalic">National Lung Screening Trial</span> &#40;NLST&#41; y el <span class="elsevierStyleItalic">NEderlands Leuvens longkanker Screenings ONderzoek</span> &#40;NELSON&#41; demuestran una reducci&#243;n de la mortalidad que justifican la implantaci&#243;n del cribado en poblaci&#243;n de riesgo&#46; Nuestro objetivo es presentar los resultados de supervivencia del programa de cribado de CP m&#225;s amplio de Espa&#241;a con tomograf&#237;a computarizada de baja dosis &#40;TCBD&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">M&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se analizaron los datos del programa Internacional de Detecci&#243;n Precoz de CP &#40;IELCAP&#41; en Valencia&#44; Espa&#241;a&#46; Este programa reclut&#243; fumadores o exfumadores con una edad entre 40-80 a&#241;os&#46; Se comparan los resultados con otros programas de similar tama&#241;o&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Un total de 8&#46;278 participantes fueron reclutados con al menos dos rondas de seguimiento&#44; hasta noviembre de 2020 &#40;62&#44;8&#37; varones&#41;&#44; realizando una media de seis rondas de cribado por individuo&#46; Diagnosticamos 239 tumores en 12 a&#241;os de seguimiento&#46; El adenocarcinoma fue el tumor m&#225;s frecuente con un 61&#44;3&#37; en estadio I&#46; Las tasas de prevalencia e incidencia fueron de 1&#44;5&#37; y 1&#44;4&#37;&#44; respectivamente&#44; con una tasa de detecci&#243;n anual de 0&#44;17&#46; Las tasas de supervivencia c&#225;ncer espec&#237;fica a cinco a&#241;os fueron del 90 y del 80&#44;1&#37; a 10 a&#241;os&#46; La adherencia fue de 96&#44;84&#37;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusi&#243;n</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La experiencia del programa m&#225;s amplio de Espa&#241;a demuestra que la supervivencia se mejora cuando se realiza en equipos multidisciplinares con experiencia en CP y es similar a programas similares&#46;</p></span>"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Median and interquartile range or percentage are shown in parentheses&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">COPD&#58; chronic obstructive pulmonary disease&#59; LC&#58; lung cancer&#59; LDCT&#58; low-dose computed tomography&#59; p-y&#58; pack-years&#46;</p>"
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                  \t\t\t\t">55 &#40;52&#8211;59&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">57 &#40;53&#8211;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">56 &#40;53&#8211;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">58 &#40;55&#8211;62&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1142 &#40;37&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2513 &#40;48&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3655 &#40;44&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Months of follow-up</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">72 &#40;44&#8211;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">73 &#40;49&#8211;90&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">72 &#40;48&#8211;87&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">89 &#40;66&#8211;126&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">92&#46;5 &#40;52&#8211;130&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">LDCT follow-ups</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;4&#8211;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;5&#8211;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;5&#8211;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;3&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Family history of LC</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">707 &#40;8&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">978 &#40;11&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1685 &#40;20&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21 &#40;31&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;23&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Emphysema in baseline LDCT</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;0001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;071</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6970&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Minimal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">307&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">672&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">979&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">185&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">252&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">COPD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;0084</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;76</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">325&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">438&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">763&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  """
              ]
            ]
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        ]
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&#46; of LDCTs&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
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      ]
      4 => array:8 [
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        "tabla" => array:3 [
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pre-existing on LDCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Emerging on LDCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Incidence of LDCT</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">239&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">LC rate&#47;100&#44;000</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">433&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">nc&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Incidence individual&#47;year</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">LC stage</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup"><span class="elsevierStyleSmallCaps">2</span></span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58&#44;911<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;117</span>Fisher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;1214</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>I&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161 &#40;67&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">76 &#40;61&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">85 &#40;73&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22 &#40;9&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;7&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;19&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;21&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">19 &#40;16&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;4&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8 &#40;6&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;1&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Surgery</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;4575</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-surgical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">44 &#40;18&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Segmentectomy&#47;lobectomy</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">188 &#40;79&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">94 &#40;39&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">96 &#40;39&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pneumectomy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;1&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;1&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Refused surgery&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;0&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;0&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Women&#58; 0&#46;61 &#40;0&#46;35&#8211;1&#46;06&#41;Men&#58; 0&#46;74 &#40;0&#46;60&#8211;0&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not published&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLCST4104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#8211;70 yearsAnnual &#40;5 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;03 &#40;0&#46;66&#8211;1&#46;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01 &#40;0&#46;82&#8211;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MILD4099&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#8211;75 yearsAnnual &#40;10 follow-ups&#41; or biennial &#40;5 follow-ups&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yearly&#58; 1Biennial&#58; 0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yearly&#58; 0&#46;5Biennial&#58; 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;73 &#40;0&#46;47&#8211;1&#46;112&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;94 &#40;0&#46;73&#8211;1&#46;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LUSI4052&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#8211;69 yearsAnnual &#40;5 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;8 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;72 &#40;0&#46;45&#8211;1&#46;116&#41;Women&#58; 0&#46;31 &#40;0&#46;1&#8211;0&#46;94&#41;Men&#58; 0&#46;92 &#40;0&#46;54&#8211;1&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;98 &#40;0&#46;79&#8211;1&#46;22&#41;Women&#58; 0&#46;82 &#40;0&#46;47&#8211;1&#46;42&#41;Men&#58; 1&#46;02 &#40;0&#46;80&#8211;1&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DANTE1264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#8211;74 yearsAnnual&#44; 5 follow-ups&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;35 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;54 &#40;0&#46;41&#8211;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;65 &#40;1&#46;42&#8211;1&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NLST5&#46;3454&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#8211;74 yAnnual &#40;3 follow-ups&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;4 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;85 &#40;0&#46;75&#8211;0&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;94 &#40;0&#46;88&#8211;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">P-IELCAP2989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8805;40 y&#46;Annual &#40;3 follow-ups&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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