Developing Lung Cancer Screening Strategies

Lung Cancer screening recommendations being developed

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

(RxWiki News) After one of the largest clinical trials ever conducted, the medical community has demonstrated that screening for lung cancer saves lives. The next step is to put these and other research findings into perspective to develop screening strategies that work around the globe.

The International Association for the Study of Lung Cancer (IASLC) is working with other lung cancer organizations around the world to define screening recommendations that offer the highest protection against a disease that takes thousands of lives a year.

"Talk to your doctor about lung cancer screening that makes sense for you."

Earlier this year, the IASLC released results from the National Lung Screening Trial (NLST) that involved more than 50,000 people. The trial found that screening smokers annually with low-dose spiral computed  tomography (LDCT) for three years reduced lung cancer deaths among smokers by 20 percent, as compared to conventional chest x-rays.

The trial also found that lung nodules were picked up in 25 percent of the patients who were screened, 96 percent of those nodules were not malignant.

In an interview with dailyRx, Fred R. Hirsch, M.D., Ph.D., professor of medicine and pathology at the University of Colorado Cancer Center, said, "This trial provided overwhelming clinical evidence that this type of screening is very effective."

Dr. Hirsch says there are a number of unanswered questions, some of which are currently being studied in clinical trials. These questions have to do with defining what is a positive [for cancer] nodule, determining the figures to be used as positive and negative predictive values, and zeroing on the population(s) that need lung cancer screenings.

"Imaging technologies need to be studied and the cost of screenings need to be further evaluated," Dr. Hirsch said. "And we need to determine if other methodologies can be used to provide more accurate screening results."

The IASLC has set up a committee to define the optimal approaches for lung cancer screenings. The group will focus on six components lung cancer screening

  1. identifying high risk individuals
  2. developing radiological guidelines
  3. developing guidelines for clinical work-up of "indeterminate nodules"
  4. creating guidelines for reporting on cancerous nodules
  5. defining recommendations for interventions of suspicious nodules
  6. integrating smoking cessation programs into future national screening programs

In a news release announcing this initiative, Professor John Field, co-author of the NLST study, chair of the IASLC Task Force on CT Screening and director of the lung cancer research program at the University of Liverpool Cancer Research Centre, said "This is a high priority for the IASLC since strategic screening has the potential to change the face of lung cancer in the coming years."

A report on findings from an NLST workshop was published in the December 15, 2011  issue of the Journal of Thoracic Oncology.

Reviewed by: 
Review Date: 
December 19, 2011
Last Updated:
December 20, 2011