Annual CT detects early-stage lung cancer, saves lives

December 01, 2003

CHICAGO - Annual computed tomography (CT) screening is an effective diagnostic tool for detecting early-stage lung cancer in smokers and for reducing mortality rates, according to two ongoing studies from the 10-year Early Lung Cancer Action Project (ELCAP) in New York.

"More than 80 percent of the diagnosed lung cancers we found in initial and annual repeat CT screenings were Stage I - the most curable form of lung cancer," said Claudia I. Henschke, M.D., Ph.D., principal investigator of the studies and professor of radiology and division chief of chest imaging at New York Hospital/Cornell Medical Center in New York City.

Lung cancer is the leading cause of cancer death among men and women, and more people will die of lung cancer than of breast, colon and prostate cancers combined, according to the American Cancer Society. Lung cancer has no early warning signs and a tumor may be the size of an apple by the time it is detected, often because of symptoms like shortness of breath, hoarseness, coughing up blood and unexplained weight loss.

Dr. Henschke presented the findings today at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

ELCAP: Original Cohort Study (1993-2003)

Multiple annual CT screenings were performed on 2,968 high-risk subjects to determine the proportion of lung cancers diagnosed on repeat CT screenings compared to those diagnosed from symptoms in between the screenings. The study also looked at the number of deaths due to lung cancer after long-term follow-up.

Cancers were classified as annual repeat screening diagnosis (findings on a low-dose CT scan 11 to 13 months after the last screening) or as an interim diagnosis (symptoms appearing within 12 months after the last screening). Among the 29 cases diagnosed, 28 were screen-diagnosed and one was interim-diagnosed, indicating that annual screening was frequent enough to diagnose early-stage lung cancer.

Long-term follow-up of patients with screen-diagnosed lung cancer who underwent surgery also showed a high cure rate.

"Through these screenings we will determine how many patients are cured," Dr. Henschke said. "Depending on the resulting long-term follow-up, we hope that CT screening will be made widely available to high-risk smokers and former smokers."

Co-authors are David F. Yankelevitz, M.D., Ali O. Farooqi, William J. Kostis, Ph.D., and Dorothy I. McCauley, M.D.

NY-ELCAP: A Multi-Institutional Study (1999-2003)

NY-ELCAP was designed to evaluate the effectiveness of annual CT screening in high-risk subjects at 12 medical institutions throughout the state of New York. Participants - 6,318 men and women, age 60 or older, who had no history of cancer and smoked at least one pack of cigarettes a day for 10 years - underwent low-dose CT of the lungs and chest and were added to the ELCAP annual report cases. As of November 2003, annual CT screenings have been performed on 4,658 people based on a positive finding in an earlier screening. Again, more than 80 percent of the lung cancers detected were Stage I.

"CT screening can help save lives," Dr. Henschke said. "Without it, about 85 percent of lung cancers that physicians diagnose are more advanced."

Stage I cancer is typically small (no larger than 10 millimeters in diameter) and localized in the lungs without spreading to the lymph nodes. The average cure rate for patients when Stage I lung cancer is removed is 60 percent to 70 percent, while the cure rate for more advanced types of lung cancer - Stage II and later - is less than 5 percent, according to Dr. Henschke.

Co-authors of the studies are Matthew D. Rifkin, M.D., Samuel Kopel, M.D., Donald L. Klippenstein, M.D., Arfa Khan, M.D., and Leslie J. Kohman, M.D.; and John H.M. Austin, M.D., David D. Mendelson, M.D., Robert Heelan, M.D., Terence A.S. Matalon, M.D., Peter W. Wiernik, M.D., and David H. Gordon, M.D.
-end-
RSNA is an association of more than 35,000 radiologists, radiation oncologists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.

Note: Copies of 2003 RSNA news releases and electronic images will be available online at www.rsna.org/press03 beginning Monday, Dec. 1.

For additional ELCAP information, visit www.NYELCAP.org and http://ICScreen.med.cornell.edu.

Editor's note: The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA newsroom at 312-949-3233.

Radiological Society of North America

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.