Routine lung cancer screening not advised

[Christine]

Thu Sep 13, 2007 1:32AM BST

NEW YORK (Reuters Health) - Guidelines released Monday by the American College of Chest Physicians (ACCP) indicate that at present lung cancer screening with CT scanning and other methods is generally not warranted outside of research studies.

In a larger, accompanying report, the group lists 260 recommendations that should be followed in the prevention, screening, diagnosis, staging, and treatment of lung cancer. Both sets of guidelines are published in a supplement to the journal Chest.

After reviewing previous study findings, the research team, led by Dr. Peter B. Bach, from Memorial Sloan-Kettering Cancer Center in New York, concludes that screening with CT imaging or certain sputum tests, simply does not reduce lung cancer deaths, even in high-risk groups, such as heavy smokers.

According to the investigators, one of the problems is that current research on CT and sputum screening has focused primarily on lung cancer detection rates, not on whether patient outcomes are actually improved. Studies addressing this question are underway, but the answers will not be available for years.

Based on a lack of solid evidence supporting the following practices, the group makes three recommendations:

--Do not use CT to screen for lung cancer outside of trial settings.

--Do not use chest X-rays to screen for lung cancer.

--Do not use sputum tests to screen for lung cancer.

"Population screening for lung cancer is not recommended and may, ultimately, put the patient at risk for further complications," Gene L. Colice, vice-chair of the ACCP lung cancer guidelines, said in a statement.

The guidelines also advise against the use of vitamins, particularly beta-carotene, vitamin A, and vitamin E, as a means of preventing lung cancer. In the case of beta-carotene, use of this vitamin may actually increase the risk of the cancer.

According to the report, there is also no solid evidence that aspirin helps prevent lung cancer or reduces lung cancer deaths.

By contrast, for the first time, the guidelines support the use of certain alternative treatments as in addition to conventional therapy. Massage therapy is recommended when anxiety or pain is present, and acupuncture is advised for fatigue, shortness of breath, and poorly controlled nausea and vomiting.

SOURCE: Chest, September 2007.

[KatieB]

oh wow....interesting

I was at the National Lung Cancer Partnership meeting in Chicago during ASCO- and they debated this very topic for us.

The debate included doctors and researchers for each side.

The Pro-side concluded that earlier detection meant a better chance at a cure, but their study was only 5 years long...

One of the things brought up on the other side was that although MORE cases of lung cancer was found earlier by use of CT screening- the overall survival rates because it was found earlier did not decrease the "death" rate and quality of life was deminished earlier due to treatments. BUT that study did not include other health factors and the fact that people died from other things during that time....

It's just my personal opinion, and my experience with lung cancer patients on a personal level, that finding this cancer early, especially when surgery can be a viable option, definitly improves survival of this disease. We've seen it right here.

So I will decide for myself to continue with my cxr. each year and a ct-scan every couple of years.

Thanks so much for posting this Christine. I am going to find out who wrote that article and WHO their sponsors are. LOL

[Christine]

I agree with you Katie. I have been watching a couple of nodules for almost two years now. My last official wait and see CT scan is scheduled for April. But, I plan to continue with annual scans just keep track of them. Peace-of-mind is priceless.

[Kasey]

Hey Christine.......my hubby watched nodules for 2 years as well. His local doc says ~ DONE with scans. BUT, my very wonderful, skilled doc at NIH has also been monitoring them. Fred is NOT his pataient, but I believe that Fred got just as much (if not more even) attention than if he were. At any rate, the NIH doc says that no way is Fred done with scans.....once a year still. So there you have it!!! We gotta be vigilant for ourselves!

Good luck with them and thanks for all the information too! Much appreciated.

Kasey

[john]

Everyone needs to also weigh the risk of the increased radiation from tests. It probably is wise to let Drs know if other tests have been done to keep track of the exposure.

It seems like from people's responses on here that this is not a huge concern by their Drs. I just would think that a young healthy 20 year old with few risk factors would want annual CT scans.

If someone is really young the frequency of tests and the ammount of radation should be monitored, because the tests can also cause cancer.

I think the low dose or spiral CT scans have a much less radiation exposure (though I am not 100% on this)

[Christine]

Thanks Kasey. My intention is to get annual scans although, I agree with John about the radiation. It's a tough call either way.

[recce101]

"Christine" Guidelines released Monday by the American College of Chest Physicians (ACCP) indicate that at present lung cancer screening with CT scanning and other methods is generally not warranted outside of research studies.

HOGWASH, in my ever-so-humble opinion. And please understand that I have nothing against hogs (except the human kind).

Aloha,

Ned

[sharonjo]

Hey,

I'm with Ned - Hogwash!

Sharon