Lung-Cancer Study Results That Will Take Your Breath Away

CT scans more effective in detecting lung cancer than chest X-rays

/ Author:  / Reviewed by: Joseph V. Madia, MD

“We have the opportunity to realize the greatest single reduction of cancer mortality in the history of the war on cancer,” said James. L. Mulshine, a research official at Rush University Medical Center in Chicago.

Now that’s a bold proclamation by any standard.

Mulshine’s referring to the long-awaited results of a recent study looking at the effectiveness of computerized tomography (CT) scans versus traditional chest x-rays in diagnosing lung cancer. If you look at the study’s findings, his optimistic assessment may not seem so outrageous: More than 53,000 middle-aged and elderly people who once smoked heavily or currently smoke heavily found 20 percent fewer deaths among those who underwent annual screening via CT scans. The striking results prompted the National Cancer Institute, which sponsored the trial, to halt the study early to alert the public and study participants.  

CT scans provide a three-dimensional image of the lungs, instead of the two-dimensional perspective chest X-rays offer. CT scans are also more sensitive and more likely to spot a tumor earlier, when the cancer is more easily treatable.

But if you smoke or used to smoke, it’s important to not rush out and demand an annual CT scan – which costs about $300 a pop and is not usually covered by private insurance or Medicare for lung-cancer screening – without first weighing the consequences. As with many medical procedures, there are risks involved. CT scans deliver high amounts of radiation, which may also cause cancer over time. (A standard chest CT delivers 10 to 15 millisieverts of radiation, while a chest X-ray delivers about 0.1 millisieverts.)

Dr. Robert Rapoport, a radiologist at St. Peter's Hospital and president of the New York Society of Radiologists, said that for older people with a long history of smoking, the benefits of CT scans outweigh the risks.

“The concern is that people will start using it too frequently and too soon,” Rapoport said. He said the effects of CT scans will be less significant for older people. Potential overdiagnosis and needless surgeries are another concern, according to Otis W. Brawley, the American Cancer Society's chief medical officer.

During the study, which began in 2002, 442 people in the X-ray group died of lung cancer compared to 354 in the CT scan group.   

Of course, the most effective deterrent against lung cancer is to never smoke or to stop smoking if you light up, even occasionally.

You might also take a liking to pistachios as an added safeguard. Recent studies suggest that a diet that includes a daily dose of pistachios, rich in a form of vitamin E, may help reduce the risk of lung and other cancers.

“Higher intakes of gamma-tocopherol, which is a form of vitamin E, may reduce the risk of lung cancer,” said Ladia M. Hernandez, senior research dietitian in the Department of Epidemiology at the University of Texas M. D. Anderson Cancer Center.

Regardless of your proclivity for nuts, if you are a smoker or an ex-smoker, it might be a good idea to schedule a CT scan or chest X-ray. Talk to your doctor before it’s too late. Lung cancer claims some 159,000 lives each year. That’s more than breast, colorectal, pancreatic and prostate cancers combined.

Pistachio, anyone?

Reviewed by: 
Review Date: 
November 9, 2010