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Probability of Lung Cancer Overdiagnosis with LDCT Screening Addressed Using NLST Data
Date:12/9/2013

Philadelphia, PA (PRWEB) December 09, 2013

An analysis of data from the National Lung Screening Trial (NLST), the results of which were published today in JAMA Internal Medicine, suggests that more than 18 percent of lung cancers detected by low-dose computed tomography (LDCT or low-dose CT) may be indolent.

“This is another important piece of information that helps us to better understand the benefits and risks of lung cancer screening,” said the study’s lead author Edward F. Patz, Jr., MD, James and Alice Chen Professor of Radiology and Professor of Pathology, Pharmacology, and Cancer Biology, Duke University School of Medicine, Durham, NC. “The NLST provided encouraging data demonstrating that lung cancer screening with low-dose CT reduces death from the disease. Despite this good news, however, there are inherent risks in any mass screening program, and one of those risks is the probability of overdiagnosis.”

Overdiagnosis seeks to detect occult disease in asymptomatic individuals and is often an intrinsic feature of screening, Patz went on to explain. In the current study, overdiagnosis was defined as the detection of a cancer that would not otherwise have become clinically apparent.

Study investigators found that the probability that any lung cancer (all types and stages) detected by LDCT screening represented an overdiagnosis was 18.5 percent. The probability that an LDCT-detected non-small cell lung cancer—by far the most frequently diagnosed lung cancer type—represented an overdiagnosis was 22.5 percent. The overdiagnosis rate for bronchoalveolar lung cancer with LDCT screening was 78.9 percent.

“In current clinical practice, patients with nonaggressive lung cancers are treated the same as any other patient with lung cancer, because it is generally not possible to distinguish indolent lesions from more aggressive tumors,” Patz said. “Better biomarkers and imaging techniques are needed
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