Dear CT Insider,
Lung cancer screening has been, well, sucking up a lot of oxygen in CT this past month, and it's not hard to see why.
First, it's because lung cancer is a big, expensive disease that claims some 160,000 lives a year in the U.S. alone. Second, although the 2011 National Lung Screening Trial (NLST) showed that routine CT screening of long-term smokers could save at least 20% of the lives this disease claims by finding it early, deciding who should be screened was another question entirely.
That task was left to researchers poring over the evidence from multiple studies over the years, who naturally have different ideas about what the research says.
On May 20 their work was unveiled when the Journal of the American Medical Association published the first screening guidelines to account for NLST's robust mortality benefit. Its investigators recommended a screening protocol that hewed closely to NLST's winning formula: i.e., screening only smokers ages 55 to 74 with a 30-pack-year history -- and no one else.
In a talk at the American Thoracic Society (ATS) meeting the next day, a speaker essentially backed up the conservative view expressed in JAMA, saying that the evidence points to rapidly dropping benefits and rising costs once lung cancer screening goes much beyond NLST's narrowly targeted screening population.
But the narrow view didn't sit well with screening advocates, who proceeded to throw mud on the new guidelines. They charge that failing to screen lower-risk groups -- such as those with a family history of lung cancer -- would amount to a death sentence for hundreds of thousands of other at-risk individuals who don't qualify for screening. You'll find our stories on the response here (part 1) and here (part 2).
Meanwhile, another study discussed at ATS showed how lung cancer risk is higher in individuals with emphysema. Finally, in our CT Insider Exclusive, a study has revealed new evidence of heightened risk in patients with chronic obstructive pulmonary disease in the lung cancer screening population. Get the details from AuntMinnie.com contributing writer James Brice by clicking here.
You'll find all this and more in your CT Digital Community. We invite you to scroll down through the links below, too, for the rest of the news about radiology's most dynamic modality.
