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Controversial Screening Test for One of the Deadliest Types of Cancer

There's no deadlier type of cancer than lung cancer. According to the American Cancer Society, it is estimated that 174,470 new cases of lung and bronchus cancer were diagnosed in 2006 -- and an estimated 60% of those patients will die within a year. In fact, more people die of lung cancer than of colon, breast and prostate cancers combined.

But a recent study, published in The New England Journal of Medicine, shows that low-dose computed tomography (CT) scanning -- where X-ray equipment rotates around the patient and provides detailed, cross-sectional images of the lungs -- can catch lung cancers early and may dramatically improve a patient's chances for long-term survival. In fact, the 10-year survival rate of the 412 people in the study who had Stage 1 lung cancer was estimated to be a remarkable 88%.

That's a remarkable result, but what's even more remarkable is that groups like the American Cancer Society, the International Association for the Study of Lung Cancer and the US Preventive Services Task Force have yet to recommend CT scans for the early detection of lung cancer.

The issue? Some critics say that the scans can result in a high number of false positives that can lead to tougher, more invasive testing. While similar arguments are made against mammograms for breast cancer, the pulmonary biopsy can be much more invasive than a breast biopsy. Invasiveness aside, the biggest issue critics raise is that this wasn't a controlled, randomized study pitting traditional X-rays against CT scans -- and that's the type of study the medical community relies on to make big decisions regarding treatment.

But, according to Claudia I. Henschke, MD, PhD, principal investigator of the study and a professor of radiology at the Weill Cornell Medical College in New York City, that argument misses the point -- the control groups should be at the treatment level, not at the diagnosis level. Simply put: "You have to diagnose the cancer, and then you treat the cancer -- and that's where the control arms should be and that's where they were for this study," Dr. Henschke says.

So what does this mean for you? Regardless of what the national organizations are saying about CT screening, if you're a smoker or former smoker who has smoked for 20 years or more and are now over age 55, Dr. Henschke recommends that you talk to your doctor about screenings, and ask him/her to help you find a nearby cancer center that is experienced in low-dose CT screening for lung cancer. (For more information on the screenings and screening centers, visit the International Early Lung Cancer Action Program Web site at www.ielcap.org.) And keep pushing until you get the information you need. As Dr. Henschke says, the health-care system responds to what people are interested in, so your interest could get this screening offered in more places -- and help save even more lives.

Be well,

Carole Jackson

Bottom Line's Daily Health News


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