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CT lung cancer screening no cure-all for smokers
Source: (cancerfacts.com)
Tuesday, June 10, 2008
OAK BROOK, Ill. (June 10, 2008) – Screening for lung cancer with computed tomography (CT scans) may help reduce lung cancer deaths in current and former smokers, but it won't protect them from other causes of smoking-related death, according to a new study.
Led by Dr. Pamela McMahon, senior scientist at Massachusetts General Hospital and instructor in radiology at Harvard Medical School in Boston, researchers published their findings in the July issue of the journal Radiology.
"Our study suggests that screening may be one way to reduce risk of death from lung cancer," McMahon said in a prepared statement."However, the number-one goal should still be to quit smoking, because it will reduce risk of death from many causes, including lung cancer."
For the study, researchers at Harvard and the Mayo Clinic in Rochester, Minn., set out to determine the long-term effectiveness of CT screening for lung cancer by entering data from Mayo's helical CT screening study of 1,520 current and former smokers into the Lung Cancer Policy Model (LCPM). This is a computer model of lung cancer development that factors in screening findings, treatment results and long-term outcomes. Using the model allowed researchers to interpret available data while waiting for long-term, randomized clinical trials to be completed.
"We used a carefully developed computer model of lung cancer to simulate individuals who smoke and/or develop lung cancers and go on to get screened or treated," McMahon said. "It's sort of like the computer game 'The Sims,' except there are no graphics, and smoking and lung cancer are the main events."
The LCPM projections showed that, at six-year follow-up, the patients who had undergone five annual screenings had an estimated 37 percent increase in lung cancer detection, compared with those who had not been screened. This resulted in a reduction in lung cancer-specific mortality of 28 percent compared to those who weren't screened. However, the reduction in death from any cause was only 4 percent in the screening group compared to the unscreened group. In other words, even though those who were screened died less often from lung cancer, they died of other lung disease instead.
Fifteen-year follow-up showed even less advantage for the screening group with a 15 percent reduction in lung cancer-specific deaths, but only a 2 percent better chance of surviving all other types of smoking-related lung disease.
"Our study fills in a piece of the puzzle but does not solve it," McMahon said. "We are hopeful that randomized trials conducted by the National Cancer Institute will show a benefit from screening. Until then, patients should think carefully about undergoing a test that has no direct evidence of benefit."
According to the Centers for Disease Control and Prevention, lung cancer is the leading cause of cancer death in the U.S. and is responsible for more deaths annually than breast, prostate and colon cancers combined. The American Cancer Society estimates 168,840 U.S. deaths will be attributable to lung cancer in 2008. Approximately 87 percent of lung cancers are caused by smoking. Smoking is also related to deaths from several other types of cancer, as well as heart and respiratory diseases.
SOURCE: adapted from a press release provided by Radiological Society of North America.
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