FRIDAY, Jan. 11 (HealthDay News) -- New recommendations from the
American Cancer Society say that older current or former heavy
smokers may want to consider low-dose CT scans to help screen for
Specifically, that includes those aged 55 to 74 with a 30
pack-year smoking history who still smoke or who had quit within
the past 15 years. Pack-years are a calculation made by multiplying
the number of packs of cigarettes smoked a day by the number of
years of smoking.
"Even with screening, lung cancer would remain the most lethal cancer," said Dr. Norman Edelman, chief medical officer at the American Lung Association. He noted the cancer society guidelines are similar to the ones from the lung association.
The new recommendation follows on the results of a major U.S.
National Cancer Institute study, published in 2010 in
Radiology, that found that annual CT screening for lung
cancer for older current or former smokers cut their death rate by
Edelman stressed that the study does nothing to change the fact
that smoking prevention and cessation remain the most important
public health challenge there is.
"Screening is not a way to make smoking safe from cancer deaths, and certainly does nothing to prevent smoking-related deaths from chronic obstructive pulmonary disease and heart disease," he added.
The cancer society recommendations also emphasize smoking
cessation counseling as a high priority and stress that CT
screening is not an alternative to quitting smoking.
CT screening should only be done after a discussion between
patients and their doctors so people fully understand the benefits,
limitations and risks of screening. In addition, screening should
only be done by someone experienced in low-dose CT lung cancer
screening, the cancer society stressed.
These new guidelines were published in the Jan. 11 online
CA: A Cancer Journal for Clinicians.
Results from the 2010 trial indicated that deaths from lung
cancer in specific high-risk groups could be reduced by annual CT
screening. "These findings indicate that the adoption of lung
cancer screening could save many lives," the cancer society
As with any guidelines, however, recommendations may change over
time as more people are screened and new data are analyzed.
Despite the lifesaving benefits of screening, there are still
some harms and limitations. Among these are missed cancers, anxiety
caused by abnormal results, the need for additional tests and
biopsies, investigation of other findings not related to lung
cancer and exposure to radiation from repeated testing, the cancer
The cancer society hopes these guidelines will help inform
people at high risk for lung cancer about finding lung cancer
early, when it has the best chance of being treated.
Many questions remain, Edelman noted.
"The most prominent is which groups who have lower risks of lung cancer than the group studied will benefit from screening. That is, at what point, in terms of risk factors, will the risks of radiation and biopsy of benign tumors outweigh the risk of cancer," he said.
There are not only important medical questions, but also
economic ones since issues of increased costs and insurance
coverage are yet to be addressed, Edelman said.
Another expert, Dr. Michael Unger, a doctor with Allied
Healthcare Associates in Northbrook, Ill., said that "it has been
proven repeatedly that mere chest X-ray screening is insufficient
to provide any benefit to survival."
That said, there have been several studies showing a survival
benefit by screening high-risk individuals with low dose CT scans,
"Whether or not such screening recommendations are accepted by Medicare and private insurance companies will eventually determine how broadly these recommendations are implemented," Unger said. "I believe only a small number would pay for such a scan out of their own pocket."
For more on lung cancer, visit the
American Cancer Society.
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