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Study Suggests a Role for Lung Cancer Screening, but Questions Remain
A large, uncontrolled, prospective study of annual lung-cancer screening using spiral CT suggests that the technique detects the disease when it is largely curable, but questions remain about the utility of this approach in real-world settings.
Researchers used spiral CT to screen some 30,000 asymptomatic people with various risk factors for lung cancer, then repeated the screening for most of them within 7 to 18 months. The screenings detected lung cancer in almost 500 participants, 85% of whom had stage I disease. Based on a median follow-up of 40 months, the researchers estimate that the 10-year survival rate for participants with stage I cancer was 88%.
Writing in the New England Journal of Medicine, the authors conclude that spiral CT screening of people at risk for lung cancer could prevent some 80% of deaths from the disease. But an editorialist cautions that "biases such as lead time and overdiagnosis could have been introduced in the final analysis of mortality," and that "the question of cost-effectiveness remains unanswered."
Link: Journal Watch General Medicine summary (Free)
Link: NEJM article (Free abstract; full text requires subscription)
Link: NEJM editorial (Subscription required)
Link: New York Times story (One-time registration required)
Published in Physician's First Watch October 26, 2006