National Lung Screening Trial results published in the print abstract of an article in the New England Journal of Medicine this month (August, 2011) showed 20 percent fewer lung cancer deaths among those at high risk for lung cancer who were screened with CT scans compared to those screened with chest X-rays.
There were "20 percent fewer lung cancer deaths among trial participants screened with CT" (trial participants were heavy current or former smokers ages 55 to 74).
Deaths from all causes, including lung cancer and other causes like heart attacks, were "6.7 percent lower in those screened with low-dose…CT relative to those screened with chest X-ray."
The trial studied 53,454 participants. More than 10,000 provided tissue samples to create a biorepository for future research. Those with lung tumors removed surgically were asked to provide samples to supplement the biorepository, according to the National Cancer Institute.
A CT screening (not typically covered by insurance as of 2010) costs about $300, according to the NCI.
"If lung cancer deaths were excluded, the differences in all causes of mortality between low-dose helical CT and chest X-ray were not statistically significant," the Cancer Institute reports. In other words, the risk-of-extra-deaths category basically included only those who smoked.
It's important to note the age range of study participants, because if you're younger or older the results might not apply to you. Also, there's risk to any type of screening.
For example, "among the possible harms of low-dose helical CT are the cumulative effects of radiation from multiple CT scans; surgical complications in patients who prove not to have lung cancer; and risks from additional diagnostic work-ups for findings unrelated to potential lung cancer, such as liver or kidney lesions," the National Cancer Institute says.
Another problem is "false positives" — screening tests that show potential lung cancer that turns out not to be so. The total false positives were 96.4 percent in the CT group and 94.5 percent in the chest X-ray group.
The results showed 247 deaths per 100,000 person-years in the CT group versus 309 deaths in the X-ray group.
"The number (of heavy smokers) needed to screen with low-dose CT to prevent one death from lung cancer was 320," the full text of the journal article says.
Smokers who quit smoking, over time, improve their risk to the point where, eventually, their risk of death equals that of the general population. The National Cancer Institute says you reduce your chance of dying prematurely by half if you stop smoking by age 50 and by 90 percent if you stop by age 30.
"Winona Health is offering a FREE four-session Smoking Cessation Program beginning Thursday, September 1. The group meets four consecutive Thursday evenings from 6 – 7:15 p.m. in the Parkview Conference Room located on the first floor of the hospital," the health center announced today (August 23, 2011).
There are also smoking cessation services, including low-cost services at some locations, in Rochester, Minnesota at Olmsted Medical Center, Mayo Clinic, the Salvation Army and other locations.
(Special thanks to Mayo Clinic Youtube producers for their video on this topic.)
Pulse on Health
By Jeff Hansel, member Association of Health Care Journalists
Health Reporter for the PostBulletin.com, 18 1st Ave. S.E. in Rochester, Minnesota 55904
Twitter Hansel's Pulse: @Jeff Hansel