Despite the prevalence of lung cancer, researchers have only recently developed an effective technique for screening those most at risk for developing the disease: smokers.

CT Scans Best Lung Cancer Screening Bet For Smokers

Written by Ronny Bachrach on November 9, 2015. Posted in Digital Radiography and PACS, Hardware

November is Lung Cancer Awareness month. According to the American Lung Association, the disease is the deadliest of all cancers for both men and women. Despite the prevalence of lung cancer, researchers have only recently developed an effective technique for screening those most at risk for developing the disease: smokers.

As many as 90 percent of all lung cancer deaths can be attributed to small cell and non-cellular instances of the disease – particularly aggressive forms of lung cancer that develop as a result of smoking. Over 130,000 lung cancer-afflicted smokers or former smokers die each year. 

Fruitless Findings
According to The New York Times, pulmonologists spent decades searching for effective, early-detection technology. Researchers first postulated that the chest X-ray might be used for detecting lung cancer in smokers, as chest X-rays are widely used for spotting dangerous lung abnormalities like pneumonia and sarcoidosis, reported the National Heart, Lung and Blood Institute. However, the National Cancer Institute put an end to this vein of research.

In 2011 the NCI published a study in the Journal of the American Medical Association that revealed X-rays don't reduce lung cancer deaths in smokers, reported the National Health Institute. The study tracked 155,000 men and women, aged 55 to 75, for a period of 13 years. 45 percent of the participants were non-smokers, 42 percent were ex-smokers, and 10 percent were active smokers. In the end, lung cancer killed a total of 2,443 participants, 1,213 of whom underwent annual chest X-rays.

CT Scan Study Brings Hope
Around the same time that the NCI released the results of its study on chest X-rays, the National Lung Screening Trial published research on low-dose computed tomography and its effectiveness in detecting lung cancer in smokers, reported The New York Times. According to the NLST, researchers followed over 55,000 active and ex-smokers, aged 55 to 74, with a history of smoking at least 30 packs per year. Participants underwent either annual chest X-rays or LDCT scans. The study found that participants whom underwent low-dose CT scans were 15 to 20 percent less likely to die from lung cancer than X-ray recipients.

Post-Study Reaction
In response to these studies, cancer prevention organizations released screening guidelines recommending LDCT scans for heavy smokers. In 2013, the American Cancer Organization published lung cancer screening guidelines in the journal CA: A Cancer Journal for Clinicians. The organization recommended that heavy smokers aged 55 to 74 receive regular LDCT scans. And, the U.S. Preventive Services Task Force put out similar recommendations, reported Time magazine. The Centers for Disease Control and Prevention took a more intense track and advised smokers to undergo annual LDCT scans. 

Insurance Companies Pick Up The Slack
Within most of the studies exalting the effectiveness of this screening, researchers note the potential drawbacks, including high false-positive rates and high costs. According to The Wall Street Journal, the typical scan costs around $400. Early this year, the government attempted to address the fiscal implications that come along with these tests. The New York Times reported that Medicare will now cover annual LDCT scans for Part B recipients aged 55 to 77 with a history of smoking. In order to receive the reimbursement, Medicare recipients must organize meetings with their physicians to determine if LDCT scanning is warranted, reported Forbes.  

Some cancer organizations rejoiced over the news. 

"It will save tens of thousands of lives," Lung Cancer Alliance CEO Laurie Fenton Ambrose said in an interview with NBC News. "We think it's a transformative moment for our community." 

Others in the field reacted to the news with more trepidation, keeping in mind the downsides associated with preventive LDCT scans – most notably, false-positives and invasive follow-up tests like biopsies. And, even if LDCT scans detect lung cancer in older patients, treatment might not even be a possibility, as surgery becomes riskier with age. Plus, many of the older individuals subjected to LDCT scans suffer from multiple, possibly deadly health issues.  

"If I find a teensy lung cancer in a 77-year-old with heart disease, I may not have done him any favor," Dr. Douglas Arenberg, medical director of the Department of internal Medicine at the University of Michigan's medical school, said in an interview with The New York Times. 

Still, proponents of preventive LDCT scanning are hopeful.

"Finally, they got it right!" Dr. Klauss Lessnau, a pulmonologist at Lenox Hill Hospital, said in an interview with Forbes. "Lung cancer is the number one cancer in the country and has a higher incidence than all other cancers combined – we have to do something about this epidemic." 

   

Ronny Bachrach

Ronny Bachrach

Marketing Director at Viztek LLC
Responsible for all marketing activities including, press, advertising, trade show coordination, website management, dealer and customer communications.
Ronny Bachrach
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