WVU Physicians Address Study of CT Scans in Early Detection of Lung Cancer

MORGANTOWN, WV—  According to Geoffrey Graeber, M.D., co-director of the comprehensive lung cancer program at the Mary Babb Randolph Cancer Center at WVU, CT scans may be more expensive than a chest x-ray when it comes to detecting lung cancer, but  they are cheaper than a funeral.

Dr. Graeber was responding to a recent study regarding the value of CT scans in the early detection of lung cancer.

The study, Survival of Patients with Stage I Lung Cancer Detected on CTScreening,” appears in the October 26 issue of the New England Journal of Medicine.

“There is not a simple answer to resolving the controversy,” says John Rogers, M.D., co-director of the Sara Crile Allen and James Frederick Allen Comprehensive Lung Cancer Program at WVU. “Clearly, the spiral CT scan is detecting lung cancer earlier in patients and they are having good survival rates.  However, sometimes the procedure picks up non-cancerous nodules.  To get the maximum benefit from CT scans, patients would have to have one every year, and that is very costly.”

Researchers from New York-Presbyterian Hospital/Weill Cornell Medical Center in Manhattan, used CT scans to screen 31,567 people in seven countries over a 13-year period.  The participants were 40 or older and at risk for lung cancer due to a history of smoking, exposure to asbestos, or exposure to secondhand smoke.

The study found that CT screening detected lung cancer in 484 people, and 412 had stage 1 cancer, the earliest phase of the disease. The study further stated that 91% of those who chose to be treated were alive 10 years later, while those who opted against treatment died within five years.

 “I believe this is compelling evidence that finding and treating lung cancer early really can change this disease from deadly to curable,” says Dr. Claudia Henschke, chief of the chest imaging division at New York-Presbyterian and lead author of the study.

Other leading experts are reluctant to recommend routine CT scanning for high-risk patients because of the high cost of the procedure, which few insurance companies will cover. They also have concerns about the number of false-positive diagnoses.

“We need a screening test for lung cancer, since most of the time the disease is picked up at a later stage,” adds Dr. Rogers.  “We need a better test, but the CT scan is what we have now and it appears to be effective. While a chest X-ray is much cheaper than a CT scan, it only provides a two-image view.  CT scans provide multiple views and are much better for early detection of lung cancer.”

“We can use CT scans in a cost-effective manner by directing them towards those already at risk – smokers, those with an environmental risk and patients already treated for lung cancer,” Dr. Graeber added.

Groups such as the International Association for the Study of Lung Cancer (ASLC) are delaying making any screening recommendations pending a National Cancer Institute trial comparing CT with X-ray screening.  The NCI results are expected to be completed in 2009.

- WVU -

For more information:
Sherry Stoneking, Cancer Center, (304) 293-4599

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