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New Lung Cancer Screening Technique Could Improve Survival

Lung cancer, screening
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WebMD Health News

Dec. 28, 1999 (Atlanta) -- Smokers can now glimpse the interior of their lungs, sufficient motivation for many to quit the habit forever, as one study has shown.

Researchers have identified a procedure that could make possible regular screenings for lung cancer, considered one of the most lethal forms of the disease. Called helical computerized tomography (CT), the scanning technology detects signs of lung cancer at a much earlier and more curable stage than when seen on a chest X-ray -- and with much lower dose of radiation than with standard X-rays or CT imaging.

Study author Georgeann McGuinness, MD, of New York University Medical Center, tells WebMD, "The technique shows a lot of promise ... and the public ... is clamoring to have this examination. However, the data is not established yet as to exactly who should be screened, how frequently should be screened ... every six months, every two years? There is a whole host of questions that should be answered."

The study involved two centers -- New York Presbyterian Hospital and New York University Medical Center -- where 1,000 healthy people over age 60, who had been smoking for more than 10 years, underwent the helical CT screening procedure in the ongoing Early Lung Cancer Action Project (ELCAP).

Reporting its second-year results in November, lead author Claudia Henschke, MD, said that better than 80% of the cancers identified in the program were early-stage tumors -- tumors that can be curable if they are surgically removed. The study was published in the July 10 issue of the journal The Lancet.

Of 31 early-stage tumors found through the screening program during the past two years, 30 of the patients have survived surgery, reports Henschke, who is with the Weill Medical College of Cornell University and New York Presbyterian Hospital.

Only one person refused surgery, and she died, Henschke says. A good number of people were convinced to quit the smoking habit forever, she adds.

The researchers interviewed 307 of the people and found that about half were still smoking at the time of the exam. "Most of these patients had abnormalities on their CT images. We showed them their films," Henschke tells WebMD. They later contacted the people, and 69, or 23%, said they'd stopped smoking.

"When you think that it's the number-one cancer killer in the world, it has a major health impact," says Henschke. "We should be able to increase even more by doing repeat annual screening. [This] opens a new world for early lung cancer intervention. It changes [lung cancer] from being such a fatal, nihilistic disease to one that has high cure rates."

While the technology is available in all large medical centers, the level of expertise in interpreting the images and managing patient care is not, says McGuinness. "A source of concern is the high number of lesions detected in high-risk patients -- those who are older and have been smoking for many years, and typically have numerous abnormalities in their lungs. The vast majority of these lesions are going to be benign, so you can't simply assume it's a cancer and send them to surgery."

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