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Lung Cancer and CT Scans-Are they worth it?

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“There was 354 lung cancer deaths among those who received CT scans and 442 among those who got X-rays.”

SEM Image Of Lung Cilia

I will be honest. I read studies all the time that indicate that early screening for cancers cause more harm than they prevent. However low-dose CT scans for long-time, high-risk smokers may be an exception to the rule.

The NYT article linked and excerpted clearly demonstrates a benefit for high-risk smokers who get low-dose CT scans. But there is considerable cost involved. And the cumulative effect of radiation may cause serious long-term health risks. More importantly, lung cancer screening can lead to over-diagnosis. The jury is out for now. But I will watch this issue and report back if I find anything.

Before anyone jumps up and down based on this preventative advance, I need to point out several possible areas of concern.

  • The cost of a lung cancer screening program and who’s going to pay for it?
  • What is the degree of false positives when a CT scan picks up an image that is not lung cancer?
  • Are the spots on CT scans lung cancer that is going to cause harm to the patient? Meaning, if the cancer is slow growing, might the patient die of something else?
  • Similar to the question above, does the CT scanning cause over-diagnosis and over-treatment?

I understand. When we all hear or read of a diagnostic technology that can identify any cancer earlier than normal, we assume the best. But, in cancer, as the saying goes, the devil is in the details…

Have you smoked a pack a day or more for 30 years or more? Have you been diagnosed with lung cancer? What stage? Have you undergone any therapy yet? If so, what? I am both a long-term cancer survivor and cancer coach. Even if lung cancer is caught early it is still aggressive cancer that requires the best of both conventional and non-conventional therapies.

To learn more about evidence-based therapies for lung cancer, please watch the short video below:

Click here to follow along with the FREE Introduction Guide.

Click here for your FREE First Questions Guide.

Scroll down the page, post a question or comment and I will reply to you ASAP.

Thanks

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


CT Scans Cut Lung Cancer Deaths, Study Finds

“Annual CT scans of current and former heavy smokers reduced their risk of death from lung cancer by 20 percent, a huge government-financed study has found. Even more surprising, the scans seem to reduce the risks of death from other causes as well, suggesting that the scans could be catching other illnesses…

The findings represent an enormous advance in cancer detection that could potentially save thousands of lives annually, although at considerable expense. Lung cancer will claim about 157,000 lives this year, more than the deaths from colorectal, breast, pancreatic and prostate cancers combined. Most patients discover their disease too late for treatment, and 85 percent die from it…

“This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial,” said Dr. Christine Berg of the National Cancer Institute

Cancer doctors and others predicted that the study’s results would soon lead to widespread use of CT scans, in particular for older smokers, who have a one in 10 chance of contracting lung cancer…

Patients wishing to get a CT lung screen will most likely have to pay the roughly $300 charge themselves, since few insurers pay for such scans unless an illness is suspected…

Each was given either a standard chest X-ray or a low-dose CT scan at the start of the trial and then twice more over the next two years. Participants were followed for up to five years. There were 354 lung cancer deaths among those who received CT scans and 442 among those who got X-rays. The $250 million study, which began in 2002, was paid for by the cancer institute and carried out at 33 sites…

Since 46 million people in the United States smoke and tens of millions more once smoked, a widespread screening program could cost billions annually. Any further refinement of those most at risk could reduce those costs. Low-dose CT scans expose patients to about the same radiation levels as mammograms. Little is known about how the cumulative risks of years of such scans would balance the benefits…”

Doctor-patient discussions neglect potential harms of lung cancer screening, study finds

“Although national guidelines advise doctors to discuss the benefits and harms of lung cancer screening with high-risk patients because of a high rate of false positives and other factors, those conversations aren’t happening the way they should be, according to a new study…

Lung cancer screening is recommended for high-risk current and former smokers, but because of the potential harms of screening, the U.S. Preventive Services Task Force and other organizations advise physicians and patients to discuss the potential risks and benefits of screening

The NLST showed that with lung cancer screening using low-dose spiral CT scan, there were about 20 percent fewer lung cancer deaths among people at very high risk from the disease compared with screening with chest X-ray. However, the trial also identified potential harms of screening, including false positive findings. More than 95 percent of lung nodules found on screening CT scans are not cancer. Because of this, many patients with abnormal results will need follow-up procedures that can be invasive, and ultimately do not find cancer. The trial also showed that screening leads to the diagnosis of cancers that, left untreated, would not have affected the patient during his or her lifetime — a phenomenon known as over diagnosis

Lung Cancer Overdiagnosis Rate 67% in Danish Low-Dose CT Trial

“Roughly two thirds of lung cancers detected with low-dose CT (LDCT) represent overdiagnosis (ie, detection of indolent cancers), report investigators from the Danish Lung Cancer Screening Trial (DLCST).

This rate of overdiagnosis is far higher than that found in two other major studies, the National Lung Screening Trial (NLST), which estimated that 18.5% of screen-detected lung cancers represented cases of overdiagnosis, and the Italian Lung Cancer Screening Trial (ITALUNG), which found no evidence of overdiagnosis…”

 

 

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