Screening Can Stop a Killer

Lung cancer can be detected in its earliest stages via CT scanning

(RxWiki News) More people die from lung cancer than any other type of cancer. CT scanning, however, can spot cancer in its earliest stages, so patients can get treatment to help wipe out the disease.

CT (computed tomography) screening has not been a routine part of preventative care for people at high risk of getting lung cancer.

An extensive research study showed that CT screening for lung cancer is worthwhile for certain patients. Patients with a long smoking history and other factors reduced their risk of dying by 20 percent due to CT screening.

"Ask your doctor about CT screening for lung cancer."

David Madtes, MD, director of Seattle Cancer Care Alliance’s Lung Cancer Early Detection and Prevention Clinic and director of the low-dose CT screening program, is advocating CT scanning to find cancer as part of National Lung Cancer Awareness Month in November.

According to the Centers for Disease Control and Prevention, lung cancer accounts for more deaths than breast, prostate and colon cancer combined. When the disease is found early on, the chances are greater that it can be treated successfully.

In June 2011, the National Cancer Institute published results from its National Lung Screening Trial (NLST) in The New England Journal of Medicine. The NLST was a study of 53,454 current or former smokers ages 55 to 74 with a history of 30 or more years of smoking. The trial compared two ways of detecting lung cancer: low-dose CT and standard chest X-ray. CT is basically a more developed scanning method, relying on a series of X-rays.

The findings revealed that participants who received the CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.

Based on these results, the American Cancer Society, the American Lung Association, and other medical organizations are recommending CT screening for high risk individuals.

The National Comprehensive Cancer Network considers individuals to be at high risk for lung cancer if they have these characteristics:

  • Age 50 or older
  • Smoked for 20 or more pack years (one pack of cigarettes a day for 20 years)
  • Documented high radon exposure
  • Occupational exposure to silica, cadmium, asbestos, arsenic, beryllium, chromium, nickel or diesel fumes
  • A survivor of lung cancer, lymphoma or head and neck cancer
  • A history of chronic obstructive pulmonary disease or pulmonary fibrosis
  • A family history of lung cancer

Fred Hirsch, MD, professor of medicine and pathology and associate director for International Programs at the University of Colorado Cancer Center in Denver, told dailyRx News, “This lung cancer screening study is a game changer. Some important questions need to be addressed in ongoing studies and future studies, [however], such as what does new technology mean for reducing the high false-positive rate of the screened detected nodules.”

Over 24 percent of screens were positive for non-calcified nodules (NCNs); more than 96 percent of these were found to be false-positive results on follow-up, according to the NLST.

The false-positive rate indicates the number of patients who are testing positive for cancer who do not have the disease.

The Seattle Cancer Care Alliance says that currently, low-dose CT screening is not covered by most insurance carriers. The out-of-pocket cost for a CT scan ranges from $300 to $1,500. Most follow-up care required after the exam will be covered by insurance or Medicare/Medicaid, according to SCCA.

“The economic aspects of screening also have to be clarified, but should not take away the important message that screenings reduce the lung cancer mortality by 20 percent,” said Dr. Hirsch. “The candidates as outlined in the article should absolutely talk with their physicians about this option.”

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Review Date: 
November 12, 2012