Annual screening may considerably reduce deaths due to lung cancer

Lung cancer is the number one cause of mortality in American men. In most of these cases, the disease is diagnosed too late for life saving treatment. However, a new study published in the journal Cancer has found that a considerable number of these deaths can be prevented if the people with high risk of developing lung cancer are screened annually. The study, known as the National Lung Screening Trial (NLST), conducted between 2002 and 2009, found that lung cancer mortality can be reduced by as much as 20% when high risk people are screened with low-dose computed tomography (LDCT) compared to when they are screened using chest x-ray.

For the NLST, current or former smokers between the ages of 55 and 74 who had accumulated 30 "pack-years" of smoking - for example by smoking 20 cigarettes a day for 30 years, or 40 cigarettes a day for 15 years - were considered to be high risk for lung cancer. On the basis of this criterion, around 8.6 million Americans could be considered as high risk cases for developing lung cancer. The researchers involved in the trial found that 60,000 of these people die from lung cancer every year. However, if they are screened through CT scan, 12,000 of these deaths can be prevented annually. This is because CT scan helps in identifying early stage nodules which can be removed surgically. The 20% reduction in the number of deaths can be seen as a big accomplishment.

However, critics of the study say that it is not feasible to screen all the people coming under high risk. Most of the heavy smokers are reluctant to get screened. Even if one were to screen all such patients, the costs involved would be too high. Moreover, one cannot rule out the possibility of false positive results. Not only are such results a cause of tremendous anxiety, they further jack up the cost of investigations as the patients may require further confirmatory tests. They may also lead to unnecessary lung surgeries which can be very dangerous. In view of these problems, it is better to encourage the patients to quit smoking rather than subjecting them to screening every year.


Editor: Dr. Bimal Rajalingam MBBS DNB (Resp Med)

Thursday, February 28, 2013
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