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November 4th, 2010
01:17 PM ET

CT scans cut lung cancer deaths for first time

Lung cancer screening by CT, or computed tomography, can reduce lung cancer deaths by detecting the disease at early stages, a new study from the National Cancer Institute says. It was the first time researchers saw a reduction in death as a result of lung screening, experts said.

In the National Lung Screening Trial (NLST), more than 53,000 current and past heavy smokers between the ages of 55 and 74 were screened for lung cancer by either low-dose CT scan or standard chest X-ray. Researchers found 20 percent fewer deaths in those screened by CT scan. The data were so statistically convincing the trial was stopped and the results released.

The results demonstrate that such CT screening could benefit older, high-risk patients, aid Dr. Denise Aberle, NLST national principal investigator for the American College of Radiology Imaging Network (ACRIN).

"We have the potential to save thousands of lives," if low-dose screening is implemented responsibly, and people with abnormalities are closely followed, Aberle said.

Trial participants smoked at least a pack a day for 30 years and had no symptoms or history of lung cancer. They were screened once a year for three years and followed for an additional five years.

"This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial," said Dr. Christine Berg, NLST project officer for the Lung Screening Study. "The fact that low-dose helical CT provides a decided benefit is a result that will have implications for the screening and management of lung cancer for many years to come."

However, there are some risks to CT scans. Radiation exposure even at low doses is higher than conventional X-rays. The tests can be costly and most insurance companies and medicare do not provide reimbursement, and 20 to 60 percent of scans will show abnormalities that can lead to more testing and medical procedures like lung biopsy that can result in post-operative complications.

Still, Dr. Harold Varmus, director of the National Cancer Institute at the National Institutes of Health says this is the first clear demonstration that a screening procedure can be effective in significantly reducing mortality in lung cancer. "Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease."

Dr. Otis Brawley, chief medical officer of the American Cancer Society agrees. "This is the first baby step toward adopting lung cancer screening in smokers. This is the first time we have any study that truly proves that screening smokers can save lives and can be beneficial. It really does give us some hope."

According to the NCI, it will take some time to go through the data, so it's too early to say how often people should be screened, what other populations might benefit from screening and how cost effective it will be.


soundoff (171 Responses)
  1. Bill

    Auto insurance cost you more if you have accidents. Maybe this should be done with health insurance. If you smoke, are obese, drink heavily and engage in known risk factors that increase your risk for disease and illness, then your rates are higher. When you get lung cancer after smoking 25 years, your co-pay is higher.

    Likewise healthy people pay less.

    November 4, 2010 at 18:34 | Report abuse | Reply
  2. Howie76

    Insurance companies do not like to pay for CT scans. Healthcare reform will make this a regular screening test.

    November 4, 2010 at 18:35 | Report abuse | Reply
  3. Tawny

    How about not smoking in the first place? I hear that cuts lung cancer as well...

    November 4, 2010 at 18:36 | Report abuse | Reply
  4. larry s

    For all you nay sayers out there,I was one of the individuals in this study. I was lucky to be involved early on,it has saved my life for 4 years so far(after lung surgery).I had no symptoms of lung cancer, the tumor was as small as a tip of a pin when it was found. I was a smoker but had quit 15+ years before the tumor was found,with the Spiral CT scan they were able to follow it till it was operable. This procedure saved my life.

    November 4, 2010 at 18:39 | Report abuse | Reply
  5. mommajam

    My father died of lung cancer in June of last year. He had been a smoker, but had quit over 30 years ago....it can still get you. Sadly also, he had a CT scan for another reason 2 years ago, and they saw what they thought was a "vein" on the side of his trachea. A year later, when other symptoms developed, they realized the "vein" was a tumour wrapped around his trachea-inoperable. I have since learned -on the internet- that a large portion of lung cancer starts OUTSIDE of the lungs. More attention needs to be paid to this...if the doctors knew what they were seeing (as they should have) they could have caught it in time. More research needs to be done on early detection of lung cancer–many people die of lung cancer who have NEVER smoked, and lung cancer kills more people every year than of colorectal, prostate and ovarian cancer combined.

    November 4, 2010 at 18:42 | Report abuse | Reply
  6. Mary

    12 years ago, as a 47 year old NON SMOKER (but with parents that had been heavy smokers) I had a chest ct, becasue my primary was a cautious man. My lung was resected. I have not had any recurrance. Today there is a productive taxpaying person thanks to that ct. I have follow up ct's each year. I had a very small tumor and have been told how lucky I was more times than I can count. And as a cancer survivor, instead of people congratulating me, they treat me as if I were the guilty one. I never smoked, but I am guilty becasue? It would be nice if people could be a little more compassionate about people that have survived lung cancer as they are breast cancer survivors. My question is: is a ct saved your life or your mother or father's lfe, woud it be worth it?

    November 4, 2010 at 18:45 | Report abuse | Reply
    • Bitsurfer

      I too am 47, and barely smoked 20 years ago. I was diagnosed with Stage 4 Lung Cancer this past summer. I was only diagnosed after I pushed doctors to take CT and MRI images of a growing pain in my hip. Turns out it was a metastatic tumor. Further tests showed it came from a lung tumor (non-small cell adenocarcenoma). I've had hip surgery, radiation of the hip and multiple rounds of chemo. Yesterday's PET/CT scan showed progress with tumor shrinkage and reduced uptake. Without CT scans I'd be a dead man walking. Now I go into tomorrows Chemo KNOWING it is working, thanks to the CT scan. Explain to my 10 and 12 year olds why CT scans are more harmful than they are worth.

      November 4, 2010 at 21:30 | Report abuse |
  7. Docman

    I think quitting smoking might save a few thousand more lives. Prevention is much better than early detection. BTW that is not a a CT scan pic, it is a linear accelorator used in radiation oncology!

    November 4, 2010 at 18:46 | Report abuse | Reply
  8. Jean

    Come on... why do us addicted smoker fools get kicked around so much for our smoke related illnesses?
    What about the obese? What about the drunks?
    We are all paying for them too.

    Signed.... quit smokin two years ago.

    November 4, 2010 at 18:50 | Report abuse | Reply
  9. Larry Donahue

    How do CT scans save lives? Nothing in this article or others say how exactly they save lives. Lung cancer can't be cured so knowing you have it earlier does not seem to make any difference except you live with the knowledge of cancer longer and endure a longer period of time with cancer tharapy. Seems drug companies just want you to use more of their drugs and the people who do CT scans want more business.

    November 4, 2010 at 18:57 | Report abuse | Reply
    • Adam Rizzo

      Hi Larry actually my moms lung cancer was detected two weeks after a hip replacement by a CT. Because it was detected early she was able to have have it removed surgically without radiation or chemo. It's been five years and she is still cancer free.

      November 4, 2010 at 21:11 | Report abuse |
    • DoctorV

      Yeah sorry Larry, you're wrong there. Early lung cancer is frequently cured. Locally advanced lung cancer is seldom cured (the 15% quoted above is probably close, depending on the treatment given). The endpoint of this study was not how many tumors are diagnosed, rather how many lung cancer deaths were prevented. Hopefully these people go on to live much longer assuming a heart attack or stroke doesn't shortly do them in instead.

      November 5, 2010 at 00:28 | Report abuse |
  10. SkipM

    STOP SMOKING!!!!! People moan about the high cost of healthcare.... one more expensive test for a disease that is caused 85% of the time by smoking.

    November 4, 2010 at 19:22 | Report abuse | Reply
  11. BRAD

    The idea of performing these CT's on groups of people like this is so rediculous that I just have to ask why would the study be done in the first place??? It sounds like a waste of research money! Who's gonna be paying for these CT's?? Of course if you give every person in the country CT's, MRI's, etc... you will find early stages of lots of disease processes! You dont need an advanced degree to figure that out. Even the smokers have to agree with that. Maybe they can use the money they would be spending on cigarettes to pay for their own CT's

    November 4, 2010 at 19:23 | Report abuse | Reply
  12. icedawg

    Three years ago through a CT scan my wife was diagnosed with bronchoalveolar carcinoma, a NSCLC (non-small cell lung cancer). This type is probably hereditary, even present in non-smokers. Fortunately caught early they were able to remove the lesion thorascopically. She did chemo following as a precaution. The doctors have scanned her every six months. Last year it reappeared in another spot in the lobe. Again they caught it early and they were able to remove it. This kind does not spread outside of the lungs and if caught early can usually be surgically removed. Sometimes it can show up in multiple spots at the same time. Not good. A particular mutant type of BAC actually responds to a particular drug that targets it. It can also respond to radiation, too. The surgeon said that he sees the day coming when surgery will not be the preferred treatment, rather they will manage the condition and you will probably die of something else. The point is that progress is being made through research and trial and error. Fund the research, fund the research.

    November 4, 2010 at 19:35 | Report abuse | Reply
  13. Francis

    The Japanese a-bomb survivor data is insightful here.
    They find radiation has no effect on lung cancer in heavy smokers. But a strong interaction for light smokers.
    So CT scans for early detection in heavy smokers is very smart.
    For light smokers or non-smokers the radiation dose is problematic and the risk benefit ration should be considered carefully.

    November 4, 2010 at 19:39 | Report abuse | Reply
  14. shirley

    wow , what about all the obesity ghat causes cancer? i am always amazed at how many people want to be so critical, and act like they are perfect, which we all know that no one is. Why are they so mad, because it is not for them?

    November 4, 2010 at 19:52 | Report abuse | Reply
  15. Jeanne

    U guys need 2 know abt lung cancer gestation.
    After u have stopped smoking
    It is 14 yrs until u r safe.
    But n the meantime u probably have gotten bronchitis and emphysema.
    So if u smoke now u have 2 learn 2 stop. Now. Every time BEFORE u put a cigarrette in your mouth, say u r kids and spouses' r other significant others
    Name. Before u smoke.
    My Dad died of end-stage
    Emphysema. On oxyen 4 years after a perforated bowel surgery-he couldn't wean from his ventilator.
    I did 7 years doing PFT testing (lung function testing)
    And 30 yrs as Respiratory Therapist.
    Cig. -The only product when used as directed
    Will kill u.

    November 4, 2010 at 20:10 | Report abuse | Reply
  16. MDDOC

    Sorry, but I suggest everyone does a little math. The lung cancer death rate in the scan group was 1.32% In the xray screening group it was 1.65%, for a benefit of 0.33%. That means you'd have to screen about 303 smokers to prevent 1 lung cancer death over 5 years, and that person is still more likely to die of something else than cancer. If you screen 1000 people, you save 3 lung cancer deaths over 5 years but 2 would die of something else anyway. And in the mean time, all the people screened by CTs would have a whole bunch of incidental findings that would lead to anxiety, extra tests, extra biopsies, and extra costs. Sounds like a bad deal to me.

    November 4, 2010 at 20:27 | Report abuse | Reply
  17. PatientInformation

    The National Comprehensive Cancer Network – NCCN is a good site also for lung cancer patients. They have new lung cancer patient guidelines. http://www.nccn.com/patient-guidelines.html

    November 4, 2010 at 20:36 | Report abuse | Reply
  18. Oh Shelly

    I have a friend who was diagnosed with Lung Cancer about 10 yrs ago he treated it with natural remedies and he is still cancer free. I believe in a lot of Prayer and naturpath it works as more and more people is doing it. I say weigh ur options do u research if u r a smoker or a non-smoker who is always near a smoker I say try out other option b4 considering CT's or Chemo r Surgery etc. I'm sure there is a natural remedy out there somewhere that u can put to use while u r smoking or a non-smoker near a smoker prevention works

    November 4, 2010 at 20:44 | Report abuse | Reply
  19. MountainDoc

    I applaud the efforts of the NLST and NCI researchers! What a great first step in knowing how to screen high-risk individuals and catch more cancers in their early stages when they are resectable/treatable. I'll look forward to reading the cost analysis, but I bet this will be cheaper than when we find stage IV lung cancers and dump $100K+ into chemo/radiation/surgery in the last few months (which frequently does nothing to help the patient's patient, quality of life, or even length of life).

    These are the things I'm glad our tax dollars go toward...as opposed to bailouts.

    November 4, 2010 at 20:46 | Report abuse | Reply
  20. Reality Check

    Here is a sad truth. My husband quit smoking in his 30's. He ran 35 miles a week and ate healthy. He had a checkup every year and never once did his doctor suggest a chest x-ray, but was always given a clean bill of health. And of course we didn't think of it either. My husband thought he was in great shape and healthy.

    At 52 my husband died of lung cancer. When I asked one of his doctors why my husband wasn't told he should have a chest x-ray at his yearly doctor visits, the doctor told me it is not 'cost-effect.' So, there you go.It is not cost effect...can you imagine how cost effective it was for my husband or our children?

    Insist on your chest x-rays. Pay for them yourself. If your doctor will not order one for you, find one that will.

    November 4, 2010 at 21:04 | Report abuse | Reply
  21. DrJim

    They have got to be kidding! A test with a 25% false positive rate is not even remotely acceptable for a screen. Just because patients with cancer have a lower death rate from cancer (a highly debatable point) does not mean we should do these tests. Let me show you some numbers always giving the edge to the CT:

    Assume the incidence of cancer is 0.1% in this population (it isn't this high)
    Assume the test picks up all cancers (it doesn't)

    That means for every 1 cancer detected there a 247.5 false positives. IF THE TEST IS POSITIVE YOU ARE 247.5 TIMES MORE LIKELY TO BE CANCER FREE!!!

    Give me a break.

    November 4, 2010 at 21:20 | Report abuse | Reply
  22. katie cox

    2 weeks, 3 days and 11 hours too late for my dad who died of lung cancer in pomfret, ct. Korean war vet, chief of.engineeeing for.state of.ct worked.with aspestos before it was identifed as dangerous.

    Better luck for the next dedicated, educated war vet

    In memory of my DAD

    November 4, 2010 at 21:28 | Report abuse | Reply
  23. US-First

    What I don't get is why are they working so hard to save smokers? Talk about wasted medical expenses. If the smoker can afford to pay the bill then fine but if Medicare is asking me to foot the bill in taxes then forget it! Whatever happens to a smoker as the result of smoking is the devil they made the bargain with.

    November 4, 2010 at 21:34 | Report abuse | Reply
  24. Reality Check

    US First-For the same reason people try to save cold fish like you.

    November 4, 2010 at 21:46 | Report abuse | Reply
  25. widow

    I was a widow at age 49, with 4 college age kids. My 52 year old husband died of lung cancer as a NON-SMOKER. Lived and went through every treatment in the book for 3 years. He was a physician, and also in excellent health. Exercised several times a week and really took great care of himself. So of course this is the LAST disease we would have ever expected. He would even move to another area of a restaurant (before so many went smokefree) if we were seated next to a smoker, mainly because the smoke would stop up his head . Needless to say, he also had an aunt die of lung cancer at his age, and also a cousin. So he may have been genetically predisposed to the disease. WHICH means anything that can be done for detection early, when it comes to the health of my children, would be greatly appreciated on my end:) Also, I am a supporter of The Lung Cancer Alliance which someone wrote of earlier. My daughter used "lung cancer awareness" as a platform for a scholarship program she was involved with. It always hurt to know that the stigma of smoking is always the blame for lung cancer by most people.

    November 4, 2010 at 22:01 | Report abuse | Reply
  26. John

    These things are doing 200+rpm and approaching the physical limits of materials... how much faster can you spin a 1000lb rotor? They're now using air-bearings instead of ball-bearings to gain some speed, but all manufacturers have the same technology. anyways my point is the big focus now is dose reduction with better algorithms and computing power. We're going to see the benefit-to-risk ratio continue to rise as the dose decreases. The data from the study is at least 8 years old, there have been many improvements from then so I’m sure the results are better than reported.

    On a lighter note… did you know the Beatles are partly responsible for CT? Their label EMI, made so much money off the Beatles that they funded reaserch of a guy named Hounsfield to invent... the EMI scanner in the early 70s. So, blame it all on John Lennon.

    November 4, 2010 at 22:23 | Report abuse | Reply
  27. Bob

    Getting people to quit would lower lung cancer deaths 80%.. Stop driving cars would cut it down to 99%..

    November 4, 2010 at 22:34 | Report abuse | Reply
  28. Gmoney

    Just another way that smokers cost taxpayers money. Why should we worry about saving their lives if they aren't concerned enough to save their own? Stop smoking.

    November 4, 2010 at 22:38 | Report abuse | Reply
  29. Tanya

    In civilized countries, every person has a free mandatory chest X-ray once a year.

    November 5, 2010 at 00:25 | Report abuse | Reply
  30. MRI/CT LADY

    After being in health care for 32 years I have realized human beings will always find something to worry about. Before CT SCanners, MRI Scanners, Nuclear Medicine Scanners, PET Scanners, etc, people only had to worry about dying from cancer. Health Care has evolved, but unfortunately, some people haven't. By the way, thanks Doc, I thought that was a Nuc Med Camera.

    November 5, 2010 at 00:30 | Report abuse | Reply
  31. k

    who cares let them die, this will just mean our insurance rates will go up

    raise taxes on cigarettes, what a joke this world is, the weak and the screw ups are the ones who are rewarded in our world

    November 5, 2010 at 00:49 | Report abuse | Reply
  32. Ray

    K: It's the weak and/or screw-ups who have taken us out of the dark ages. Please take a look at the innovators, artists, politicians, engineers, etc. of the last 500 years who meant anything for our development and there was a hell of a lot of drinking, smoking and carousing. You've already been rewarded by them. R

    November 5, 2010 at 02:44 | Report abuse | Reply
  33. Jeanne

    Lung drs usually look
    At pack years-the
    Number of pack of cig smoked per day times the number of packs per day e.g. If u smoked
    For 10 years but 2 packs a day, that would b 20 pack years; 40 yrs times 2 pack a day would be 80 pack years.
    If u went into a smoking cessation program if it couldnt stop u from smoking take along a loved one that still smokes and 4 a check up scan. U might just save their life or yours.

    November 5, 2010 at 02:50 | Report abuse | Reply
  34. Michelle

    It is true, CT scan can be beneficial in detecting early lung cancer. I had one 8 years ago, discovered a very tiny malignant tumor in my lungs, had surgery, no other treatment; repeated CT scans three times a year for the first four years following surgery, and now I have to go just once a year for a CT scan. It is worth, trust me.

    November 5, 2010 at 03:19 | Report abuse | Reply
  35. aviator

    Joe S: Another self-righteous, educated beyond his intelligence bigot. No one seems to include the Billions $$$ (with a "B") in TAXES generated by tobacco in their hyperbole. Much less the Billions $$$ (with a "B") paid to the states AND Fed Gov't in the on-going "Tobacco Settlerments". Eliminate tobacco entirely and see what happens to your tax rates on seemingly innocuous items.

    November 5, 2010 at 03:36 | Report abuse | Reply
  36. Jeanne

    Please remove from the blog i
    Intially wrote because I didnt write it. It is somethg like you are so dumb. On my first post I believe. It's at the start and finish of my post. I do not insult people in an open forum. Please correct now. I can be reached at 573.535.4959-prefer a text.
    DO NOT POST THIS STATEMENT AND AT ONCE REMOVE THE PART 'YOU R SO STUPID R DUMB'
    Chk this out at once. Jeanne fisher

    November 5, 2010 at 04:35 | Report abuse | Reply
  37. Jeanne

    Do not post this
    After my first blog, someone posted at the begining at the end and then u went further, u posted my cell phone number that I gave 2 confirm that it had removed.
    Do u understand
    If my phone number is called by a lot of callers, I will talk 2 an atty jeanne

    November 5, 2010 at 07:14 | Report abuse | Reply
  38. Mike

    My father is 75 and smoked for 60 years. He had a chest x-ray done annualy for the past 15 years by the VA. He always came back with a clean bill of health (at least no tumors ever showed up). This past April he became ill with pneumonia. Couldn't shake it. Ended up going to a private hospital because fortunately he had good insurance. Had a chest x-ray and came back negative. No tumors. Pneumonia kept coming back. Finally they did a ct scan. First time found a tumor in his lungs the size of a mans fist. He had stage 4 lung cancer. If only it was found earlier he may have stood a chance.

    November 5, 2010 at 08:08 | Report abuse | Reply
  39. Jeanne

    Correct errors
    My first input, entered YOU R STUPID at the begining of my post. I did not write that. I asked u remove that and gave u my cell phone no. tell u to not post something with my cell no.
    U posted again.
    Dont post this and remove the u r so stupid comment, remove third post in complaing about
    Not posting that you having posted these 3complaints like this same one
    Give this To a SUPERVISOR NOW!

    November 5, 2010 at 08:24 | Report abuse | Reply
    • LMAO

      Uh, I think you should just quit posting. These posts go to the wall immediately without being reviewed, so if you write something (i.e. cell number) it will instantly be on the website for all to see. And just posting again is not going to solve the problem. I suggest you try to get a hold of one of the website administrators if you want that taken down. As for legal action, IMHO it is your own fault you posted your number in a public forum. Read the "Terms of Service" next time before you click Post.

      November 5, 2010 at 13:03 | Report abuse |
  40. Sylvia Sproul

    A CT scan saved my life. In a CT scan for a non lung cancer problem a tiny spot was seen on my right lung. 18 months later it was removed and found to be cancer. After surgery I was cancer free and two years later show no signs of cancer.

    November 5, 2010 at 10:46 | Report abuse | Reply
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