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Who Should Get a CT Scan to Screen for Lung Cancer?
Date:7/1/2011

By Jenifer Goodwin
HealthDay Reporter

THURSDAY, June 30 (HealthDay News) -- Annual low-dose CT scans cut the death rate from lung cancer by 20 percent in heavy smokers and formerly heavy smokers, compared to those who get annual chest X-rays, according to the results of a major National Cancer Institute study released on Wednesday.

Experts are calling the findings a major advance in efforts to combat lung cancer deaths. By catching the cancer early, the tumors can be removed surgically -- hopefully before they've spread and become very difficult to cure.

"This is a momentous time in the history of public health research," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "The NLST [National Lung Screening Trial] is the best-designed and best-performed lung cancer screening study in history."

Yet the findings raise as many questions as they answer, said Dr. Harold Sox, a professor emeritus of medicine at Dartmouth Medical School who wrote an accompanying editorial to the study published in the June 30 issue of the New England Journal of Medicine.

"Screening for lung cancer can reduce the death rate from lung cancer, and that's a very important, game-changing result," Sox said. "It's an enormous advance. But the next questions are: What should we do about it? And how should we maximize the results for the societal investment it's going to take?'"

The National Lung Screening Trial included more than 53,000 current and former heavy smokers aged 55 to 74 who were randomly selected to undergo either a "low-dose helical CT" scan or a chest X-ray once a year for three years. Helical CT, also called a "spiral" CT, provides a more complete picture of the chest than an X-ray, experts said. While an X-ray is a single image in which anatomical structures overlap one another, a spiral CT takes images of multiple layers of the lungs to create a three-dimensional image.

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