Screening of lung cancer with CT scans may save many lives

29 September 2005

Hoffman Estates, Ill., USA. A new international study shows that early detection of lung cancer for the highest-risk patients could mean the difference between life and death. 97% of tumours found through CT scans, in non-symptomatic patients, are potentially curable with surgery alone.

Cancer of the lung is now the leading cause of death from cancer in both men and women. Lung cancer kills more individuals than cancers of the breast, colon, and prostate combined. It is estimated that there will be over 1.5 million deaths from lung cancer worldwide next year alone — more than 4000 new victims daily.

"Even if you have stopped smoking in the last 20 years you're not home free," explained renowned Cornell cancer researcher Claudia Henschke, MD, Ph.D., during a recent meeting of Chicago-area oncologists, radiologists, and pathologists sponsored by the Alexian Brothers Hospital Network. Henschke presented research results from a new international study showing that early detection of the disease for the highest-risk patients (current or ex-smokers, age fifty or older) could very well mean the difference between life and death.

The study's findings included renewed hope in the possibility of early detection through the promising scientific advances of CT (Computed Tomography). One of the most compelling aspects of Henschke's study showed that 97% of tumors found through CT scans,  in non-symptomatic patients, are still confined to their original site and are potentially curable with surgery alone. CT is an imaging modality that shows over 300 cross-sectional pictures of the chest, from the tip to the base of the lungs.

Early Stage I lung cancer has a cure rate of nearly 87%, and in certain subgroups it is even higher. The results of the most widely used screening methods to detect lung cancer during these earliest stages, including chest x-rays and sputum cytology, have been disappointing. By the time a lung tumour is visible on an x-ray, it usually has spread beyond the site where it arose. Currently only 16% of lung cancers are found at a potentially curable stage. At the time of diagnosis, 75 percent of patients with lung cancer already have symptoms (persistent cough, chest pain or recurring pneumonia or bronchitis) related to advanced local or metastatic disease that cannot be cured; the disease is fatal in more than 90 percent of cases overall. Such was the case with ABC World News Tonight anchor Peter Jennings, who died after a four-month battle with the disease. "That's why catching the disease early, when it's still treatable, is vital," stressed Henschke during her presentation.

Henschke's recommendation of who should get a CT scan depends on a person's smoking history. She encourages both current and former smokers, over the age of 50, to talk to their doctor about having a CT lung screening. Henschke also endorses the screening for those over age 40 who have been exposed to secondhand smoke. Dana Reeve, wife of the late Christopher Reeve, recently announced that her lung cancer diagnosis might be attributable to being exposed to secondhand smoke while working in nightclubs.

Tobacco use is still by far the most preventable cause of death from lung cancer. The health benefits of quitting smoking, at any age, are immediate and substantial. In addition to stressing the importance of smoking cessation, Henschke also reported that nearly 25 percent of those who receive a CT lung scan screening quit smoking, far above the national success rate for quitting.

The new study was done in conjunction with the International Early Lung Cancer Action Project (I-ELCAP), an international collaborative group created through the union of experts on lung cancer and related issues from leading researchers around the world. Dr. Henschke is the director of the Lung Cancer Screening Program at New York Weill-Cornell Medical Center.

The Alexian Brothers Hospital Network, operators of four hospitals in suburban Chicago, offers the CT scan for lung cancer at several of its facilities. "We hope this technology will allow those diagnosed with early lung cancer to have a more positive outcome," said Dr. Edward Diamond, a pulmonologist with the Alexian Brothers Hospital Network in attendance at the presentation. "More importantly, this has the potential to be a major breakthrough in early lung cancer detection."

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