Screening heavy smokers for lung cancer reduces chance of death, federal study finds

The Boston Globe: "Screening heavy smokers with sophisticated medical scanners modestly reduced their chance of dying from lung cancer, according to a federal study released yesterday that provides the first convincing evidence that testing could reduce the toll from the leading cause of cancer deaths. The preliminary findings from the National Cancer Institute were based on a gold-standard study that randomly assigned 53,000 current or former smokers without symptoms to be screened with a CT scanner or standard chest X-ray. Deaths from lung cancer were 20 percent lower in the CT-scan group, providing hope the tests can identify tumors early among those at greatest risk, when treatments have a higher likelihood of success and cause fewer side effects. Computed tomography scans can detect tumors as small as a pea"  (Smith, 11/5).

The Wall Street Journal: "It's the first time that a clear benefit has been shown for any form of lung-cancer screening, which is based on the assumption that finding tumors early allows patients to be treated before the cancer becomes deadly. … Lung cancer, which is mainly linked to smoking, is the leading cause of cancer deaths in the U.S., projected to kill about 157,000 people in this year, according to the American Cancer Society. One reason for its deadliness is that it is typically caught late. ... While the results released Thursday are promising, researchers and doctors involved with the study cautioned that they weren't issuing a recommendation that anyone be screened. … Screening poses a number of challenges. Potential harms include radiation exposure and complications from follow-up procedures for abnormalities that prove not to be cancer. ... It's also unclear how much this would add to the nation's health costs" (Hobson and Doreen, 11/5). 

The Los Angeles Times: "The technology involved in the screening is called low-dose spiral CT imaging, in which a complete three-dimensional image of the chest cavity can be produced during the duration of one held breath. The technology is much more sensitive than a conventional chest X-ray, but also exposes the patient to much more radiation — about the same amount associated with a conventional mammogram, according to Dr. Denise R. Aberle of UCLA's Jonsson Comprehensive Cancer Center, the principal investigator of the study. A typical spiral CT costs between $300 and $1,000 and, unless it is for diagnostic purposes, is not paid for by insurers" (Maugh, 11/5).

The New York Times: "Since 46 million people in the United States smoke and tens of millions more once smoked, a widespread screening program could cost billions annually. Any further refinement of those most at risk could reduce those costs" (Harris, 11/4).

The Washington Post: "In addition to a reduction in lung cancer deaths among those scanned, the study found a 7 percent reduction in deaths from any cause. It remained unclear why that would be the case, but researchers speculated that it might be attributable to the scans detecting other cancers or illnesses, such as heart or lung disease" (Stein, 11/4).

U.S. News & World Report: "Officials halted the $250 million study earlier than planned, given such clear results" (Hiatt, 11/4).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.