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Lung Cancer Screening Complications
I am a long-term cancer survivor whose wife has smoked cigarettes her entire adult life. When I first read about low-dose computed tomography (LDCT) and lung cancer screening I thought that my wife was the ideal candidate. And to be honest, I would love for my wife to scan her lungs regularly in an effort to identify any long cancer at an early stage.
I research and write about issues such as
- pre-cancer
- cancer prevention
- and cancer diagnostics among other issues-
Unfortunately I had read the book “Should I be tested for Cancer? Maybe not and here’s why“ by H. Gilbert Welch. At about the same time, I was reading studies about mammograms and prostate cancer testing doing as much harm as good.
The number of possible health problems that can come from simple cancer testing is remarkable. You may choose to have the test. I’m simply saying that men who have a biopsy of their prostate should understand the risk of infection.
I’m not writing this post to tear down diagnostic testing for early stage cancers. If you are a cigarette smoker and quit (maybe e-cigs and the patches will help to quit…) I understand your lungs will be healed in 10 years with the help of a nutritional supplement called curcumin.
I am simply trying to educate smokers about the good and bad, pros and cons of lung cancer screening.
What are the Pros and Cons of testing for cancer?
Pros of Cancer Testing:
- Early Detection: Testing can help detect cancer at an early stage when it may be more treatable and have a higher chance of successful outcomes.
- Improved Survival Rates: Early detection often leads to more effective treatment options, potentially increasing the chances of survival and reducing the severity of treatment side effects.
- Preventive Measures: Positive test results can prompt individuals to make lifestyle changes, undergo preventive measures, or participate in screening programs to reduce their risk of developing cancer.
- Peace of Mind: Negative test results can provide reassurance and peace of mind, reducing anxiety about potential cancer risks.
- Genetic Counseling: For individuals with a family history of cancer, genetic testing can help identify specific genetic mutations, allowing for personalized risk assessments and targeted preventive measures.
- Clinical Trials: Participation in cancer testing may open up opportunities for individuals to participate in clinical trials, contributing to advancements in cancer research and treatment.
Cons of Cancer Testing:
- False Positives: Testing may produce false-positive results, indicating the presence of cancer when it is not actually present. This can lead to unnecessary anxiety, further testing, and potentially invasive procedures.
- False Negatives: Conversely, there is a risk of false-negative results, providing a false sense of security and delaying necessary treatment.
- Psychological Impact: Positive test results can have a significant psychological impact, causing stress, anxiety, and fear, even if the cancer is treatable.
- Overdiagnosis: Some cancers detected through testing may be slow-growing and not pose a significant threat to health. Overdiagnosis can lead to unnecessary treatments and their associated side effects.
- Costs: Cancer testing can be expensive, and not all tests may be covered by insurance. Additionally, the costs associated with follow-up tests, treatments, and potential complications need to be considered.
- Invasive Procedures: Confirmatory tests for cancer often involve invasive procedures, such as biopsies, which carry their own set of risks and potential complications.
- Impact on Quality of Life: The knowledge of being at increased risk or having cancer can impact an individual’s quality of life, causing emotional distress and affecting daily activities.
Are you a smoker wondering about lung cancer screening with computed tomography? Are you a newly diagnosed cancer patient? If you would like to learn more about your cancer as well as possible side effects, send me an email-
David.PeopleBeatingCancer@gmail.com
Thank you,
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
Invasive Procedures and Complications Follow Lung Cancer Screening
“TOPLINE: After lung cancer screening (LCS), imaging and invasive procedures were performed 31.9% and 2.8% of the time, respectively. Complications during invasive procedures occurred in 30.6% of cases.
METHODOLOGY:
- Researchers analyzed data from 9266 patients aged 55-80 years who completed at least one LCS with low-dose CT (LDCT) between 2014 and 2018.
- This study used data from the PROSPR Lung Consortium.
- Results were compared with findings from the National Lung Screening Trial (NLST), a large study of smokers published in 2011.
TAKEAWAY:
- In total, 2956 patients (31.9%) underwent follow-up imaging, including CT, LDCT, MRI, or PET; 180 (0.02%) had invasive procedures, including needle biopsy, bronchoscopy, mediastinoscopy or mediastinotomy, or thoracoscopy.
- Within 30 days after an invasive diagnostic procedure, 55 of 180 patients (30.6%) experienced complications; 20.6% were major, 8.3% were intermediate, and 1.7% were minor.
- Complication rates after invasive procedures were higher in PROSPR than the NLST (30.6% vs 17.7%).
- Compared with all patients, those with an abnormal LCS were slightly older, more likely to currently smoke, reported more packs of cigarettes smoked daily, and had more comorbid conditions.
- In 2013, the US Preventive Services Task Force recommended annual LCS for certain people who smoke, on the basis of findings from the NLST.
IN PRACTICE: “We observed higher rates of both invasive procedures and complications than those observed in NLST, highlighting the need for practice-based strategies to assess variations in the quality of care and to prioritize LCS among those patients most likely to receive a net benefit from screening in relation to potential complications and other harms,” the researchers wrote.”
Rates of Downstream Procedures and Complications Associated With Lung Cancer Screening in Routine Clinical Practice
“Patients: Individuals who completed a baseline LDCT scan for LCS between 2014 and 2018…
Results: Among the 9266 screened patients, 1472 (15.9%) had a baseline LDCT scan showing abnormalities, of whom 140 (9.5%) were diagnosed with lung cancer within 12 months (positive predictive value, 9.5% [95% CI, 8.0% to 11.0%]; negative predictive value, 99.8% [CI, 99.7% to 99.9%]; sensitivity, 92.7% [CI, 88.6% to 96.9%]; specificity, 84.4% [CI, 83.7% to 85.2%]).
Absolute rates of downstream imaging and invasive procedures in screened patients were 31.9% and 2.8%, respectively. In patients undergoing invasive procedures after abnormal findings, complication rates were substantially higher than those in NLST (30.6% vs. 17.7% for any complication; 20.6% vs. 9.4% for major complications)…
Conclusion: The results indicate substantially higher rates of downstream procedures and complications associated with LCS in practice than observed in NLST. Diagnostic management likely needs to be assessed and improved to ensure that screening benefits outweigh potential harms.”