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No Survival Benefit for CT Screening for Lung Cancer

and Colin B. Begg, Ph.D., Chairman of the Department of Epidemiology and Biostatistics at Memorial Sloan-Kettering, and have been shown to be accurate in study populations like the ones analyzed.

Over the course of the studies, screening found more than three times as many lung cancers as the number that would have been diagnosed without screening, and there were ten times as many surgeries performed for lung cancer compared to what was expected. This meant that as a direct result of the test, an additional 99 people were diagnosed with lung cancer and an additional 98 had lung surgery. However, the early detection and treatment did not change the death rate. There were 38 deaths due to lung cancer, and 39 would have occurred without screening.

“The purpose of large-scale screening is to save lives, but after five years of follow-up, our data provides no evidence that CT screening prevented deaths from lung cancer,” said Dr. Begg, the paper’s senior author. “Our findings are consistent with the results of earlier studies of lung cancer screening with chest x-rays, which showed no benefit to this type of screening for current and former smokers.”

CT screening is not without risk. The radiation can become significant when the scans are repeated every year. Because the test is not very specific, it is known to have false positive results, which can lead to additional CT scans at full radiation doses and invasive procedures like lung biopsies. This study also suggests CT screening can lead to additional major surgeries to remove very small growths that look like lung cancer but do not pose a meaningful threat to the patient’s health.

“With lung cancer the number one cause of cancer deaths in the United States, the medical profession continues to seek an effective and safe approach to prevent deaths from this disease. According to our study, CT screening may not be it,” said Dr. Bach.

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