(RxWiki News) A key to beating lung cancer is finding it early on. After extensive research, the American Cancer Society now recommends CT screening for older patients with a history of smoking.
Smoking is a leading cause of cancer and death from cancer, according to the National Cancer Institute. Recently, the American Cancer Society (ACS) issued guidelines recommending screening through low-dose computed tomography (CT).
Screening is suggested for former or current smokers ages 55-74 with a 30-pack-year smoking history.
A 30-pack-year means that someone has smoked the equivalent of 1 pack of cigarettes a day for 30 years. Someone who smoked 2 packs for 15 years would also be in this category.
"It's never too late to quit smoking!"
Richard C. Wender, MD, chair of the department of family and community medicine at Thomas Jefferson University in Philadelphia and former national president of ACS, and his collaborators published the guidelines with the goal of better informing patients to detect lung cancer early on. Early detection can contribute to the decline in lung cancer deaths.
Computed tomography (CT) uses special x-ray equipment and computers to provide more detailed imaging compared with standard x-rays.
In 2010, an extensive study of 53,454 current or former heavy smokers who had participated in the National Lung Screening Trial (NLST) found that that participants who received CT scans with a low radiation dose had a 20 percent lower risk of dying from lung cancer than participants who received standard chest x-rays, according to the National Cancer Institute [NCI].
"Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography,” said the authors of these new ACS guidelines. “These findings indicate that the adoption of lung cancer screening could save many lives.”
The ACS specifically recommended CT screening for a patient who:
- is 55-74 years old, has at least a 30-pack-year smoking history, and currently smokes or has quit within the past 15 years.
- has undergone a thorough discussion of the benefits, limitations and risks of screening.
- can be screened in a setting with experience in lung cancer screening.
The scientists caution, “As with other guidelines for cancer screening, we can expect that this initial guideline will be revised as new data become available.”
They stress that there are still limitations with screening, and patients are advised to have a thoughtful discussion with a clinician about the potential benefits and harms associated with this diagnostic method.
Limitations and harms of CT screening include missed cancers, anxiety associated with abnormal results, the need for additional imaging tests and biopsies, investigation of incidental findings not related to the lungs, and exposure to radiation from repeated tests.
The published report also emphasizes the importance of quitting smoking for those who are current smokers.
While researchers are optimistic about the potential that screening high-risk patients will increase survival rates, they maintain a wait-and-see stance. "Whether community-based screening for lung cancer with low dose CT will exceed or fail to achieve the benefit observed in the NLST could be influenced by many factors,” said the authors, “and the answer awaits the results of further observation and research."
The American Cancer Society lung cancer screening guidelines were published online on January 11 in CA: A Cancer Journal for Clinicians.