Screening for lung cancer with CT scans
Posted By Peter Wehrwein On November 4, 2010
Lung cancer is usually discovered late when it’s difficult to treat and has often spread outside the lung. A reliable screening test to find it at an earlier, more treatable stage would be a legitimate breakthrough—and could potentially save thousands of lives. About 160,000 Americans die each year from lung cancer, which is more than who die from breast, prostate, and colon cancer combined.
Chest x-rays do a good job of finding small lung cancers that can be removed surgically. Why not use them to screen for lung cancer? Because at least a half-dozen studies have been done and for reasons that aren’t entirely clear, early detection with chest x-rays hasn’t translated into prevention of fewer deaths from lung cancer. And in screening, early detection is a means to an end. The real goal is preventing deaths from the disease that is being screened for (and deaths in general).
So it was big news today when the National Cancer Institute (NCI) announced today that a large study sponsored by the institute showed that screening current and former heavy smokers with computed tomography (CT) scans did, in fact, reduce the risk of dying from lung cancer by 20% compared with screening them with chest x-rays. Moreover, those who were screened with CT scans were 7% less likely to die from any cause during the study’s five-year follow-up period.
Good news, and a long time coming for those who have watched disappointing findings from the chest x-ray studies pile up.
But if today was first time that most of us heard about the National Lung Screening Trial, it probably wouldn’t be the last. It’s almost certainly going to stir up more than its fair share of controversy.
Here are a few of the hot buttons:
Of course many of our current screening tests for cancer have shortcomings, cost plenty, and are controversial. The debates about the value of mammography never seem to end. Yet we get behind screening tests for a whole variety of reasons, not the least of which is that cancer caught late is so lethal and, these days, astronomically expensive to treat.
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