In November I wrote about preliminary data from the National Lung Screening Trial, a large study funded by the National Cancer Institute that attempted to find out if catching lung cancer early with spiral CT scans made a difference. (See link 1 below for my November post.) Last week, the New England Journal of Medicine published the trial results (2) and an accompanying editorial (3).
The study randomized over 50,000 people who were
- aged 55 to 74,
- were either current smokers or had quit in the last 15 years,
- had not been diagnosed with lung cancer, and
- had a lifetime history of smoking at least 10,000 packs of cigarettes (the equivalent of smoking one pack per day for 30 years).
The study subjects were randomized to two groups. One group received annual chest X rays for three years. Chest X rays have already been proven not to save lives as a test for early lung cancer. The second group received annual spiral CT scans of their chest for three years. Both groups were followed for another three and a half years after the tests to assess for the development of lung cancer and death due to lung cancer.
The results were remarkably positive. The group receiving the CTs had a 20% lower rate of death from lung cancer. For every 320 patients screened by CT, one life was saved. That’s a number that compares favorably with other cancer screening tests, like mammography.
This is a very important discovery. Though lung cancer incidence has been declining with the decreasing number of smokers, it remains the number one cause of cancer death in the US. Use of CT screening in the appropriate groups of patients promises to significantly decrease lung cancer mortality.
So if you meet every point in the above list, talk to your doctor about a spiral CT of your chest. More importantly, if you smoke, stop. If you want to stop smoking and can’t, ask your doctor for help.
[Medical news posting resumes in two weeks.]
(1) My previous post about the National Lung Screening Trial: A Screening Test for Lung Cancer
(2) New England Journal of Medicine article: Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening
(3) New England Journal of Medicine perspective article: Better Evidence about Screening for Lung Cancer
LA Times article: Study bolsters evidence that screening reduces lung cancer deaths
Wall Street Journal Health Blog: Lung-Cancer Screening Unknowns: Who Should Get it, How Much it Will Cost