National study shows CT screening of former, current smokers reduces lung cancer deaths

November 04, 2010

WASHINGTON, DC - A large national study finds that screening current or former heavy smokers with a CT scan can reduce deaths from lung cancers by 20 percent. One potential reason for the reduction is that the scan can pick up tumors at an early stage. The study was conducted by the National Cancer Institute at 33 centers around the country including Georgetown Lombardi Comprehensive Cancer Center, a part of Georgetown University Medical Center.

The National Lung Screening Trial (NLST) involved more than 53,000 current and former heavy smokers ages 55 to 74. More than 1,800 men and women participated through Lombardi. The study compared the effects of two screening procedures for lung cancer -- low-dose helical computed tomography (CT) and standard chest X-ray.

Under Lombardi's leadership, 1,800 men and women were recruited into the clinical trial at Georgetown University Hospital as well as two other Georgetown community screening locations.

"Overall this study provides strong evidence that older patients who are at high-risk of developing lung cancer could benefit from CT screening and that's a significant finding." says Claudine Isaacs, MD, lead investigator of the NLST study at Lombardi. "We are grateful to all the men and women who participated in this important study. Clinical trials are critical to making progress in medicine."

"These results are very encouraging," says Louis Weiner, MD, director of Lombardi. "Studies like these generate so much excitement, but clearly there is much more work to be done. Lombardi and other NCI-cancer centers continue to explore effective ways to reduce lung cancer deaths including prevention efforts and by conducting clinical trials with the newest available cancer fighting drugs."

The NLST study began enrolling participants in August 2002. Participants were required to have a smoking history of at least 30 pack-years and were either current or former smokers without signs, symptoms, or history of lung cancer. Pack-years are calculated by multiplying the average number of packs of cigarettes smoked per day by the number of years a person has smoked.

The men and women were randomly assigned to receive three annual screens with either low-dose helical CT (often referred to as spiral CT) or standard chest X-ray. Helical CT uses X-rays to obtain a multiple-image scan of the entire chest during a 7 to 15 second breath-hold. A standard chest X-ray requires only a sub-second breath-hold but produces a single image of the whole chest in which anatomic structures overlie one another. Previous efforts to demonstrate that standard chest X-ray examinations can reduce lung cancer mortality have been unsuccessful.

The trial participants received their screening tests at the time of enrollment and at the end of their first and second years on the trial. The participants were then followed for up to another five years; all deaths were documented, with special attention given to the verification of lung cancer as a cause of death. As of October 20, 2010, a total of 354 deaths from lung cancer had occurred among participants in the CT arm of the study, whereas a significantly larger 442 lung cancer deaths had occurred among those in the chest X-ray group. This represents a 20.3 percent reduction in lung cancer mortality offered by CT scans compared to the X-ray group.

"Potentially, we could save thousands of lives with CT screening, but keep in mind that because smoking causes many lung cancers, we could save hundreds of thousands more if people wouldn't smoke or quit if they do," Isaacs points out.

"We're proud to be a part of this important study designed to answer critical questions," says Howard J. Federoff, MD, PhD, executive vice president for health sciences at GUMC and executive dean of its School of Medicine. "Lombardi's leadership role in the effort to reduce the burden of cancer has an impact at the national and local levels, and benefits our community directly."

"This large and well-designed study used rigorous scientific methods to test ways to prevent death from lung cancer by screening patients at especially high risk," said Harold Varmus, M.D., NCI Director, in a press release issued today. "Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease."

The NCI notes that the possible disadvantages of helical CT include the cumulative effects of radiation from multiple CT scans; surgical and medical complications in patients who prove not to have lung cancer but who need additional testing to make that determination; and risks from additional diagnostic work-up for findings unrelated to potential lung cancer, such as liver or kidney disease. In addition, the screening process itself can generate suspicious findings that turn out not to be cancer in the vast majority of cases, producing significant anxiety and expense. These problems must, of course, be weighed against the advantage of a significant reduction in lung cancer mortality.
-end-
A fuller analysis, with more detailed results, will be prepared for publication in a peer-reviewed journal within the next few months. Initial results and other information can be found on the NCI's website: http://www.cancer.gov/newscenter.

The NLST was sponsored by NCI, a part of the National Institutes of Health, and conducted by the American College of Radiology Imaging Network (ACRIN) and the Lung Screening Study group. For more information about the study, please call the NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

About Georgetown Lombardi Comprehensive Cancer Center

Georgetown Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center and Georgetown University Hospital, seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Lombardi is one of only 40 comprehensive cancer centers in the nation, as designated by the National Cancer Institute, and the only one in the Washington, DC, area. For more information, go to http://lombardi.georgetown.edu.

About Georgetown University Medical Center

Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Georgetown Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO). In fiscal year 2009-2010, GUMC accounted for 79 percent of Georgetown University's extramural research funding.

Georgetown University Medical Center

Related Lung Cancer Articles from Brightsurf:

State-level lung cancer screening rates not aligned with lung cancer burden in the US
A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden.

The lung microbiome may affect lung cancer pathogenesis and prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.

New analysis finds lung cancer screening reduces rates of lung cancer-specific death
Low-dose CT screening methods may prevent one death per 250 at-risk adults screened, according to a meta-analysis of eight randomized controlled clinical trials of lung cancer screening.

'Social smokers' face disproportionate risk of death from lung disease and lung cancer
'Social smokers' are more than twice as likely to die of lung disease and more than eight times as likely to die of lung cancer than non-smokers, according to research presented at the European Respiratory Society International Congress.

Lung cancer therapy may improve outcomes of metastatic brain cancer
A medication commonly used to treat non-small cell lung cancer that has spread, or metastasized, may have benefits for patients with metastatic brain cancers, suggests a new review and analysis led by researchers at St.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.

Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.

Read More: Lung Cancer News and Lung Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.