profession

CT scans may decrease lung cancer mortalities

Twenty percent fewer deaths occur among current and former heavy smokers screened with low-dose CTs than with chest x-rays, a new study finds.

By Christine S. Moyer — Posted Nov. 24, 2010

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Low-dose computed tomography scans might help reduce lung cancer mortalities among heavy smokers and former smokers, according to a new report. But further analysis of the findings is needed before screening recommendations can be issued for the disease, said a statistician for the study.

There is no generally accepted screening test for lung cancer. The U.S. Preventive Services Task Force said evidence is insufficient to recommend for or against screening asymptomatic people for the disease with either low-dose CT scans, chest x-rays, sputum cytology or a combination of these tests.

Results of the study, which were published online Nov. 2 in Radiology, found that CT scans decreased the mortality rate of heavy smokers and former smokers by 20.3% compared with chest x-rays. The National Cancer Institute sponsored the study.

"For the first time, we have definite proof that screening for lung cancer can reduce mortality," said Constantine A. Gatsonis, PhD, a lead statistician for the study and a professor of biostatistics at Brown University.

He encourages physicians to consider the new data when they are deciding what test to recommend for screening a patient's lungs.

Lung cancer is the leading cause of cancer-related death among men and women in the U.S., according to the Centers for Disease Control and Prevention. The NCI estimates that 222,520 new cases of lung cancer will be diagnosed this year, and 157,300 people will die of the disease.

Researchers examined data on 53,456 current and former heavy smokers age 55 to 74 who were enrolled in the National Lung Screening Trial between August 2002 and April 2004. Participants smoked at least one pack a day for 30 years and had no signs, symptoms or history of lung cancer.

About half of the individuals were randomly assigned to receive three annual low-dose CT scans, and the other half got three standard x-rays. Participants were screened when they enrolled in the study and at the end of their first and second years in the trial. Then they were followed for as many as seven years. Radiologists reviewed the images for lung nodules and masses. Participants whose tests revealed an abnormality received follow-up recommendations.

At the end of the study in October, 796 of the participants had died of lung cancer. In the group that received CT scans, 44.5% died of the disease. The figure was 55.5% among those who got x-rays (link).

The potential disadvantages of CT procedures include the cumulative effects of radiation from multiple scans and false positives that can lead to unnecessary lung biopsies.

"At the end of the day, we have to balance the risks of [lung cancer] screening with the benefits. That will be part of a more detailed analysis" of the study's findings, which will be published in the near future, Gatsonis said.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story