Many diseases pose bodily threats, even before the presentation of symptoms. In some of these cases, screening is recommended, so as to catch any incidence of the disease early enough that the worst effects can be mitigated.
A growing amount of evidence suggests that lung cancer is on this list for people with a particular background. This includes patients who are between 55 and 80 years old, have a history of heavy smoking (defined by the CDC as more than 24 cigarettes per day) and who have smoked within the past 15 years.
The recommended screening test for this cancer is a CT scan, as studies have shown them to be more effective than chest X-rays at early identification of potentially cancerous cells. Dr. Caroline Chiles, a professor of radiology in the Comprehensive Cancer Center of Wake Forest Baptist Medical Center and a principal investigator in one study about the efficacy of using CT scans to screen for lung cancer, said that for at-risk populations, exams should be done yearly to maximize the chance of catching diseases at their most curable points.
"When we're screening once a year every year we are finding early stage lung cancers that are potentially curable. We really start seeing benefit when someone stays in annual screening," Chiles told WebMD.
As this process is not without downsides, it is only recommended for people in the population that is most at-risk. There are three primary downsides to these screenings:
- False positives: When a test finds cancer in a healthy person, it immediately triggers follow-up exams, which themselves have associated dangers and costs. While not as risky as false negatives, they can nonetheless expose the patient to negative outcomes.
- Overdiagnosis: Some forms of cancer will never actually cause a problem to the patient, but are detected by early screening. A patient who would have otherwise been fine is then subject to a treatment regimen that could be dangerous.
- Radiation: While CT scans administer a relatively small dose, they are not completely radiation-free. As with any exposure to radiation, there is a risk that an otherwise healthy patient develops cancer from repeated testing.
However, despite these potential pitfalls, regular screening can have a positive effect on the lives of patients, and prevent lung cancer from spreading to other nodes in the body. In her study, Chiles noticed a distinct shift from late stage lung cancers, which have a significantly higher mortality rate, to early stage ones, which are far more treatable. Similar studies have backed up this finding, making it likely that the usage of CT scans will remain a regular fixture in the treatment of populations that are at the highest risk for these carcinomas.
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