Annual CT scans for lung cancer recommended for longtime smokers
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Smokers who've indulged in the habit for decades can benefit from routine annual low-dose CT screenings to detect the presence of early-stage lung cancers, a key government health panel said Monday.
The draft recommendation by the U.S. Preventive Services Task Force is open for public comment until Aug. 26. The final statement is expected to be officially published within three to six months.
Older smokers and former smokers -- 55 to 74 -- with a pack-a-day history should undergo annual helical CT scans, according to the task force, which estimates about 9 million people are probably eligible for screening.
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Panelists based their recommendation on the National Lung Screening Trial, a massive nationwide study of 53,000 current and former smokers. Researchers concluded in 2010 that screening reduced lung cancer deaths by 20 percent.
A second national study, a portion of which was conducted on Long Island, helped determine which types of lung nodules detected by CT scans should be biopsied to help prevent unnecessary invasive procedures.
The new screening endorsement by the influential government panel has been a long time coming.
In 2004, the task force gave the screening its lowest possible recommendation, saying there wasn't enough evidence to prove its worth. But Monday, the independent panel of nonfederal experts, which makes recommendations to primary care clinicians on screenings, counseling and preventive medications, gave the scans a grade of "B" -- a full-throated endorsement.
"Finally. Good for them," said Dr. Shahriyour Andaz, director of thoracic oncology at South Nassau Communities Hospital in Oceanside.
"The purpose of CT screening is to detect lung cancer early," said Andaz, who is also an associate professor of surgery at Hofstra-North Shore LIJ School of Medicine. He led the Long Island portion of the Early Lung Cancer Action Program, which helped determine the types of lung nodules that should be biopsied.
"You're not preventing lung cancer through CT scanning, you're detecting it at hopefully stage 1A," added Andaz, noting that long-term survival is most likely when tumors are spotted in their earliest evolutionary phase.
For Dr. Claudia Henschke, director of the Lung and Cardiac Screening Program at The Mount Sinai Medical Center in Manhattan, the panel's recommendation is vindication of her pioneering research.
She is the first doctor to theorize -- and prove 14 years ago -- that CT scanning saves lives.
For years, skeptics had denounced CT scans for lung cancer, complaining that patients would run the risk of false positives and invasive procedures that could prove costly and disabling. But the scientific evidence overwhelmingly showed lives were spared.
"The decision by the . . . [panel] to upgrade its recommendation for low-dose CT screening for lung cancer to a 'B' is a major step forward," Henschke said. "The benefits associated with CT screening, while still not fully appreciated, will continue to improve over time."
Dr. Nabil Rizk, a thoracic surgeon at Memorial Sloan-Kettering Cancer Center in Manhattan, said the panel's decision is good news for smokers -- and physicians"This is for people with a 30-year history of smoking," Rizk said.
. With the panel's recommendation, Rizk predicts Medicare and private insurers will probably cover the screening's cost, which can run anywhere from $500 to $750.
Lung cancer is a major disease burden that kills about 160,000 people annually, more than those who die from breast, prostate and colorectal cancers combined.
"Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than 200,000 people each year," said Dr. Virginia Moyer, who chairs the task force. "Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage," she said.