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Just saw this one, early screening for lc


J.C.

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Early screening could reduce lung cancer deaths

Updated Wed. Oct. 25 2006 6:35 PM ET

CTV.ca News Staff

A new study provides compelling evidence that early screening for lung cancer among high-risk groups could dramatically reduce death rates.

The results, which are to be published in the October 26 edition of the New England Journal of Medicine, find that lung cancer can be detected at its very earliest stage in 85 per cent of patients using annual low-dose CT screening.

The Toronto arm of the study screened 2,300 former smokers, and found 32 cases of lung cancer.

CT, or computed tomography, scans involve technology that views the lungs and surrounding tissue at different angles and can spot growths that are small as a grain of rice.

When detection is followed by prompt surgical removal, the 10-year survival rate is 92 per cent, according to results from the largest long-term study to determine the usefulness of annual CT screening.

Elsa Poitras was a heavy smoker for 25 years. And even though she quit the habit 17 years ago, concern she was at risk for lung cancer led her to take a CT screening. She was right: the scan showed a two-centimetre tumour, undetectable on a chest X-ray machine.

Doctors removed the tumour in January and Poitras needs no further treatment.

"I owe my life to that screening study," Poitras told CTV News.

In the absence of screening, the vast majority of lung cancers are diagnosed in later stages, when it can no longer be cured.

"We believe this study provides compelling evidence that CT screening for lung cancer offers new hope for millions of people at risk for this disease and could dramatically reverse lung cancer death rates," said lead author Dr. Claudia Henschke, radiology professor and chief of chest imaging at New York-Presbyterian/Weill Cornell Medical Center.

Among the more than 31,500 people examined in the study, CT scans detected 484 people who were diagnosed with lung cancer, 412 of whom were Stage I.

Overall, the estimated 10-year survival rate for the 484 participants with lung cancer was 80 per cent.

Remarkable advances allow doctors to use word 'cure'

Stage 1 lung cancer is the only stage at which curing the patient of cancer is highly likely, according to the researchers.

"Those Stage I diagnoses represented cases of genuine cancer," said Dr. Olli S. Miettinen, McGill professor in the Faculty of Medicine, Department of Epidemiology, Biostatistics and Occupational Health, and Department of Medicine.

"All of them were confirmed by a panel of internationally recognized experts on lung pathology; 95 per cent of the lesions were already invasive; and in all of the eight instances in which treatment was refused, the patient died of lung cancer within five years," Miettinen, one of the researchers who guided the study, said in a written statement.

The participants were 40 years of age and older and at risk for lung cancer as a result of a history of cigarette smoking, occupational exposure (to asbestos, beryllium, uranium or radon), or exposure to secondhand smoke.

There have been remarkable advances in CT scanners since the early 1990s, which allow for the detection of lung cancer in cases that it was previously near-impossible to diagnose.

In the past, CT scans yielded only 30 images, where current technology captures more than 600 images.

Cost could emerge to be an issue, as the charge for a low-dose CT screening ranges from US$200 to $300, but doctors say treatment for the earliest stage of lung cancer is less than half the cost of late-stage treatment.

The International Early Lung Cancer Action Project, which was launched by a team of researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center in 1993, has expanded into a collaboration of 38 institutions in seven countries.

With files from CTV's medical specialists, Avis Favaro & Elizabeth St. Philip

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