Over the past 30 years various efforts have been made to detect lung cancer at an early stage to reduce deaths from cigarette caused disease. Regular chest x-rays or sputum cytology have never been shown to reduce mortality from lung cancer in smokers. The introduction of CT scans raised hopes that this technology would detect enough lung cancers at an early stage to reduce mortality but multiple trials showed no efficacy until now.
In a new study using low dose ultrafast chest CT scans (also know as helical or spiral CT) in 53,500 smokers or ex-smokers age 55-74 with a smoking history of at least 30 pack years (1 pack per day for 30 years = 30 pack years or 2 packs per day for 15 years = 30 pack years) there was a 20 % reduction in lung cancer deaths compared to screening with a chest x-ray.
Since lung cancer is THE leading cause of cancer death in the USA, even this relatively small decrease in mortality would translate into sparing significant numbers of people from the ravages of this disease. Dr. Harold Varmus, Director of the National Cancer Institute states: "But these findings should in no way distract us from continued efforts to curtail the use of tobacco, which will remain the major causative factor for lung cancer and several other diseases." The trial investigators re-emphasized that, "...the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently."
The data from this study will be further analyzed to develop and propose guidelines and policy recommendations for lung cancer screening. It will take several months before these guidelines are developed and approved.
Dr. Richard D. Hurt is an internationally recognized expert on tobacco dependence. A native of Murray, Kentucky, he joined Mayo Clinic in 1976 and is now a Professor of Medicine at its College of Medicine. In 1988, he founded the Mayo Clinic Nicotine Dependence Center and since then its staff has treated more than 50,000 patients for tobacco dependence. Send your questions directly to Dr. Hurt at AskTheExpert@becomeanex.org
