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Report: Tomography Screening Could Avert 12,000 Lung Cancer Deaths Each Year in U.S.

Some health agencies remain skeptical (Feb. 25)

Screening for lung cancer with low-dose computed tomography (LDCT) in all screening-eligible current and former smokers has the potential to avert approximately 12,000 lung cancer deaths each year in the U.S. That’s the conclusion of a new analysis published online in Cancer, a journal of the American Cancer Society. By providing a national estimate of potentially avoidable lung cancer deaths, the study may help policy makers better understand the possible benefits of LDCT lung cancer screening, the authors say.

Despite substantial decreases in the prevalence of smoking, 43 million Americans are current smokers. If these smokers continue to smoke, half of them will die of smoking-related diseases, including lung cancer.

The National Lung Screening Trial (NLST) — conducted from 2002 through 2009 — found that, compared with chest x-rays, LDCT screening reduces lung cancer deaths by about 20% among current and former (those who have quit within 15 years) smokers aged 55 to 74 years who have smoked at least 30 pack-years (the equivalent of one pack per day for 30 years, or two packs per day for 15 years).

Based on the information from this study, combined with the U.S. population size and other data, Jie-min Ma, PhD, of the American Cancer Society, and his colleagues concluded that, in 2010, approximately 8.6 million Americans were eligible for LDCT screening for lung cancer, according to the criteria used in the trial. When they combined this finding with information on lung cancer death rates, they estimated that, if all screening-eligible Americans were to receive LDCT screening, approximately 12,000 lung cancer deaths would be delayed or prevented each year in the U.S.

“Our findings provide a better understanding of the national-level impact of LDCT screening, which has the potential to save thousands of lives per year,” said co-author Dr. Ahmedin Jemal. He added that, since the publication of the NLST results in 2011, several health organizations, including the American Lung Association, have recommended LDCT screening for lung cancer; however, some health agencies are still waiting for new data before making any recommendations.

In an accompanying editorial, Larry Kessler, ScD, of the University of Washington School of Public Health, noted that while the study’s findings are important, it is not clear whether a new national policy for lung cancer screening is warranted.

“The high rate of false positive tests [from LDCT screening] and the related workup costs, and the cost of treating findings that would not benefit patients, give pause, and thus it is clear why a decision has not been yet taken in this direction,” Kessler wrote.

He emphasized the importance of completing full cost–benefit evaluations of the NLST study and the need for continued smoking-cessation efforts.

Source: Wiley; February 25, 2013.

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