For heavy smokers, CT scan appears best for lung cancer screening
May 23, 2013 | by Hiu Chung So
For heavy smokers, the first and best thing they can do to fight lung cancer is to kick the habit. Then they need to be vigilant about screenings — and a new study suggests that a low-dose computed tomography (CT) scan does a better job than chest X-rays of catching lung cancers.
The findings were published today in the New England Journal of Medicine, using data from the National Lung Screening Trial (NLST). That trial involved more than 50,000 current or former heavy smokers, defined as having the equivalent of “a pack a day” smoking habit for 30 or more years.
The researchers evaluated the NLST data to determine whether initial CT or chest X-ray screenings came back with a suspicious result, and whether follow-up tests confirmed the presence of lung cancer. In the paper, they reported that initial CT scans caught more lung cancers than chest X-rays, particularly early-stage cancers that are more treatable.
The authors reported that these results are consistent with other studies in the field, “suggesting that a reduction in mortality from lung cancer is achievable at U.S. screening centers that have staff experienced in chest CT.”
Said Dan Raz, M.D., co-director of City of Hope's Lung Cancer and Thoracic Oncology Program: “This study highlights many of the findings of the NLST when it was originally published almost two years ago.”
But despite NLST’s findings that CT screenings can reduce lung cancer mortality, he added, they are not widely used due to their costs and the “seemingly high rate of false positives.”
“This study serves as a reminder of the lifesaving implications of lung cancer screening,” said Raz, who is not involved in the study.
Currently, the American Lung Association recommends that former or current heavy smokers undergo low-dose CT scans — and not chest X-rays — to screen for lung cancers.