Part I: Low-dose CT lung cancer screening for earlier disease detection

According to a recent Siemens Healthcare survey, 78% of Americans would want to know if they had a serious illness—even if no cure existed.1 Clearly, Americans recognize the “value of knowing” with respect to disease detection. With lung cancer, effective treatment is possible, provided that it’s administered to the patient at an early stage of disease development. Unfortunately, symptoms of lung cancer usually do not appear until the disease has already progressed to an advanced, noncurable stage.2 The relative 5-year survival rate for patients diagnosed with lung cancer at any stage is only 15.9%—far below the 5-year survival rates for colon cancer (64.3%), breast cancer (89%), and prostate cancer (99.2%), according to the Lung Cancer Alliance.3

Low-dose spiral computed tomography (CT) can visualize lung structures using relatively low doses of radiation. In 2011, the National Lung Screening Trial (NLST) determined that CT lung cancer screening reduced mortality from lung cancer among risk groups—that is, current smokers age 55 to 74 with more than 30 pack-years of smoking, or former smokers with that profile who quit within the past 15 years—by 20% compared to no imaging or imaging with x-rays.4 In the past 3 years, a growing number of medical organizations—including the American College of Chest Physicians (ACCP),5 the American Society of Clinical Oncology (ASCO),5 and the American Thoracic Society (ATS) 6—have announced their support for the NLST findings, urging proactive CT lung cancer screening for this high-risk group. In January, the American Cancer Society (ACS) made headlines when it, too, stated that evidence is sufficient to recommend screening high-risk patients for lung cancer with low-dose CT using the NLST criteria, provided the imaging occurs in an experienced setting.7

But despite the fact that major organizations within the medical community endorse the practice of low-dose CT screening for earlier detection of lung cancer, this imaging practice remains far from prevalent. In the conclusion of my blog, I’ll examine why this is the case—and how a change could be on the horizon in the wake of the July 29 draft recommendation issued by the U.S. Preventive Services Task Force (USPSTF).8  

*Siemens Healthcare is currently indicated for low dose lung imaging.  Siemens Healthcare is not indicated for Low dose lung cancer screening.

References

1. Siemens Healthcare Press Room. “Majority of Americans Want to Know If They Have an Illness” http://usa.healthcare.siemens.com/press/pressreleases/healthcare-news-2013-05-07-2

2. American Cancer Society (ACS). http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-detection

3. Lung Cancer Alliance. 2012 Lung Cancer Facts. www.lungcanceralliance.org

 

4. National Cancer Institute (NCI). “Lung Cancer Trial Results Show Mortality Benefit with Low-Dose CT” http://www.cancer.gov/newscenter/newsfromnci/2010/NLSTresultsRelease

5. American College of Chest Physicians (ACCP). “ACCP and ASCO Release Joint Systematic Review and Clinical Practice Guideline on the Role of CT Screening in Lung Cancer” http://www.chestnet.org/News/ACCP-Clinical-News/2012/05/ACCP-and-ASCO-Joint-LC-Screening

6. American Society of Clinical Oncology. (ASCO) “The Role of CT Screening for Lung Cancer in Clinical Practice. The Evidence-Based Practice Guideline of the American College of Chest Physicians and the American Society for Clinical Oncology” http://www.asco.org/institute-quality/role-ct-screening-lung-cancer-clinical-practice-evidence-based-practice-guideline

7. American Cancer Society (ACS). “Weighing the Benefits and Risks of Lung Cancer Screening.” http://www.cancer.org/cancer/news/expertvoices/post/2013/01/11/weighing-the-benefits-and-risks-of-lung-cancer-screening.aspx

8. http://www.uspreventiveservicestaskforce.org/bulletins/lungcandrftbulletin.pdf

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