- Screening with a low-dose CT scan dramatically reduces the death rate from lung cancer
- People who’ve been smokers or exposed to second hand smoke need to get screened more often
Now, a lung cancer screening trial reported in the New England Journal of Medicine studied 15,792 people who were randomly assigned to have either periodic low-dose CT screening or no screening. Across 10 years of follow-up, researchers found that a patient’s chance of death from lung cancer was 24 percent lower in men and 33 percent lower in women for the screening group than those who weren’t screened. On top of that, the study’s researchers estimate around 60 deaths were stopped due to the four offered rounds of screenings given to 7900 participants.
The increased accuracy of a low-dose CT is especially critical because lung cancer is often asymptomatic in the early stages. Having a low-dose CT done can help to catch the cancer before it spreads to other parts of the body and becomes harder to treat.
“It should be apparent that it is now time to widely adopt and implement LDCT screening for lung cancer. Policy decisions are still pending in many countries, as is the adoption of a LDCT screening recommendation for lung cancer by the American Academy of Family Physicians,” says Dr. Brendon Stiles, a thoracic surgeon at Weill Cornell Medical Center. “Certainly we still need to carefully consider who to screen, how often, and how to address the financial implications. However, with the publication of this new study, the second adequately powered study to show a lung cancer mortality reduction with LDCT screening, it is time to move forward.”
This confirms the evidence found by an 11-year study called the National Lung Screening Trial which also found that low-dose CT scans lower a person’s risk of dying from lung cancer, compared to traditional chest x-rays. This study, conducted by the American College of Radiology Imaging Network and the National Cancer Institute (NCI), followed 53,454 participants aged 55 to 74 who were either current or former heavy smokers. The study showed patients who had a low-dose CT were 15 to 20 percent less likely to die of lung cancer compared to those who had a traditional chest x-ray.
According to the American Cancer Society, a low-dose CT may find abnormalities such as nodules that need further examination, though these worrisome findings are sometimes found to be benign. This further work-up can be done through something as simple as another CT scan or a more invasive test such as a lung biopsy.
Who Should Get Screened?
In the United States, lung cancer is the second most common cancer for both men and women, as well as the cancer with the highest mortality rate. Though nearly 20 percent of people who die from lung cancer in the U.S. each year have never smoked or used any other form of tobacco, the American Cancer Society recommends that anyone aged 55 to 74 years old get yearly low-dose CT scans if you also meet one of the following smoking-focused conditions:
- People who currently smoke, or who have quit in the past 15 years
- Those who have at least a 30 “pack-year” smoking history (“pack-year” is defined as the number of years you smoked multiplied by the number of packs of cigarettes per day)
- Anyone who has had some sort of counseling to quit smoking
“It’s very, very hard to quit, and they’ve got so many things going through their mind and so much anxiety at the time of their surgery that I don’t have a policy, ‘hey, gotta stop smoking,'” Cornell’s Dr. Stiles told SurvivorNet in a previous conversation. I think surgery is a great learning opportunity, it’s a great time for them to be in the hospital where hopefully they’ll stop after that. But, it’s tough to really beat people up about that in my opinion,”
If you’ve been exposed to second hand smoke, also consider getting tested as the FDA reports that it causes about 7,000 people a year to die from lung cancer. The same recommendation goes for anyone who had been exposed to harmful chemicals like asbestos, commonly used for insulation, roofing, and in various paints and plastics before it was banned by the EPA in 1989. A 2017 study linked asbestos to lung cancer. For anyone who is concerned about their lung cancer risks, speak to your doctor about getting a low-dose CT scan.