Misinformation may be driving underuse of lung cancer screening

Misinformation about the harms of CT lung cancer screening may cause eligible patients to forego or not be offered the exams, according to an article published January 20 in the Journal of the American College of Radiology.

In a joint statement from the Society of Thoracic Surgeons (STS), the American Society for Radiation Oncology (ASTRO), and the American College of Radiology (ACR), a group led by Haley Tupper, MD, of the University of California, Los Angeles, addressed these misconceptions in recently published research.

“A number of recent peer-reviewed articles pertinent to CT lung cancer screening (LCS) contain substantial methodological flaws that contribute to the propagation of misinformation,” the group wrote.

Specifically, the authors highlighted three specific examples that may contribute to reduced screening knowledge and access:

• Overestimation of downstream imaging and procedural complications after LCS

• Misrepresentation of the lung cancer screening false-positive rate

• Flawed analysis of oncogenic risk associated with radiation from CT scans

As one example, the authors discussed a recent JAMA Internal Medicine study led by researchers at the University of California, San Francisco, that suggested that cancers associated with radiation from CT scans could eventually account for 5% of all new cases annually.

The analysis used the National Cancer Institute’s Radiation Risk Assessment Tool to estimate cancer incidence attributed to CT imaging, the authors noted.

“This tool primarily uses data from Japanese atomic bomb survivors beginning in 1950. Associating acute and intense radiation exposure from atomic bombings with cancer risk from CT imaging requires inappropriate extrapolation,” they wrote.

In a separate January 21 statement lauding the article, STS, ASTRO, and ACR urged clinicians and researchers to be mindful of such methodological pitfalls when interpreting lung cancer screening data and encouraged journals and the medical community to perform similarly informed, diligent peer review.

“The multi-specialty joint statement demystifies the common misunderstandings about the benefits and risks of lung screening and should increase decision-making quality and screening rate,” said Ruth Carlos, MD, editor-in-chief of the Journal of the American College of Radiology.

The full article can be found here.