Dear AuntMinnie Member,
The big news in radiology this week was the release of results from a major European randomized controlled trial on CT lung cancer screening that found screening to produce a 26% mortality reduction in men at high risk for lung cancer.
Researchers on Tuesday presented long-awaited results from the Dutch-Belgian Randomized Lung Cancer Screening (NELSON) study, which has been underway in Europe for the past 10 years. The trial compared the effectiveness of four rounds of CT screening in high-risk smokers with outcomes in similar individuals who didn't get any screening.
The 26% reduction in lung cancer mortality is better than the 20% reduction found in the landmark National Lung Screening Trial (NLST) in the U.S. The mortality reduction for women in the NELSON study was even higher, although the study included far fewer women than men.
The question is, now what? The NLST prompted the U.S. to approve reimbursement for CT lung cancer screening; will European countries follow suit? And if they do, will they avoid the pitfalls that have caused CT lung screening to fall short of expectations in the U.S.?
The uptake of CT screening has been low -- with fewer than 4% of eligible individuals being screened. This could be due to a variety of reasons:
- Under Medicare rules, high-risk individuals need a referral from a doctor to start screening. This differs from breast screening, for which women can self-refer.
- U.S. guidelines on who is eligible for lung screening have been criticized by some as being unnecessarily restrictive.
- Some physicians may not know that lung screening is now an approved exam, even though the NLST results were released in 2014.
- The fragmented nature of the U.S. healthcare system makes it more difficult to roll out large, population-based screening initiatives, especially for those younger than Medicare age.
- Finally, smokers may simply have a more fatalistic attitude about their health.
Whatever the reason, it will be interesting to see the direction Europe takes in applying NELSON's findings to the public health realm. If European countries take a cautious approach similar to what's been used in the U.S., the results most likely will also be disappointing.
Meet the Minnies finalists
On Wednesday, we released the results of voting in the second round of the Minnies, our annual event recognizing excellence in radiology.
Our expert panel has selected two candidates in each of the 14 categories, ranging from Most Influential Radiology Researcher to Best Radiology Mobile App. The winners will be announced in late October.
Do you know anyone who made it to the final round? Check out the list of finalists by clicking here, and watch this space in the next few weeks to find out who wins.
