The American Cancer Society has issued new guidelines that recommend patients between 54-74 years of age who have a smoked the equivalent of a pack a day for 30 years, and currently smoke or have quit within the past 15 years be given low dose CT screenings for lung cancer each year. The guidelines, which were published online January 11, 2013 in CA: A Cancer Journal for Clinicians, several studies including the National Lung Screening Trial (NLST), which found that people who got low-dose CT had a 20% lower chance of dying from lung cancer than those who got chest x-rays. However, other trials found no benefit from screening, particularly in people who had been light smokers, or never smoked at all.
The screening in the NLST was done at large teaching hospitals with access to a lot of medical specialists and comprehensive follow-up care. Most were National Cancer Institute cancer centers.
In addition Dr. Richard Wender, head of family medicine at Thomas Jefferson University in Philadelphia, and a former president of the Cancer Society who led the guideline panel, noted that a major drawback of low-dose CT scan is that it finds a lot of abnormalities that turn out not to be cancer but that still need to be assessed to be sure. (About 1 out of 4 people in the NLST had such a finding.) “This may lead to additional scans or even more-invasive tests such as needle biopsies or even surgery to remove a portion of lung in some people. A small number of people who do not have cancer or have very early stage cancer have died from these tests. There is also a risk that comes with increased exposure to radiation,” he noted.
“We ‘re trying to make sure we restrict harm that might come from screening such as unnecessary biopsies.
For more information, readers should consult with their doctors, or contact the American Cancer Society at 800 227-2345.