Long Island doctors are conducting an arm of an international clinical trial to screen for early signs of lung cancer using CT scans that spot tiny nodules before they become full-blown tumors, the researchers said Monday.

"Lung cancer kills more patients than colon, breast and prostate cancers combined. And, unfortunately, we are not doing too well with chemotherapy drugs, either," said Dr. Shahriyour Andaz of South Nassau Communities Hospital in Oceanside, who added that the drugs fail in a large number of patients.

Andaz is inviting smokers and former smokers 50 and older to join the hospital's Early Action Lung Cancer Project.

The project, Andaz said, is a continuation of the hospital's long-standing role in the International Early Lung Cancer Action Program, which helped establish the importance of using CT scans as a screening tool. Most nodules, Andaz said, turn out to be benign.

Three years ago, results from a separate study, the National Lung Screening Trial, demonstrated definitively that periodic low-dose scans reduce lung cancer deaths. Without screening, lung cancer is usually detected at a late stage.

Despite findings from major global studies, many smokers and former smokers still have not heard about the screening, Andaz said.

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For 2014, the American Cancer Society has estimated that 159,260 people nationwide will die from the disease -- 86,930 men and 72,330 women.

The hospital's scanning study is underway as researchers at Cold Spring Harbor Laboratory are delving into yet another part of the lung cancer problem: its extraordinary resistance to chemotherapeutic agents. Resistance is so fundamental a problem in lung cancer that Dr. Raffaella Sordella -- who is also studying the use of CT scans for early detection -- said it's a key reason for high mortality in the disease.

"What we are learning about resistance in lung cancer also applies to antibiotic resistance in bacteria," Sordella said Monday. She described a Darwinian struggle to survive mounted by cancer cells that is strikingly comparable to the struggle of pathogenic bacteria. Cancer cells and bacteria are capable of outfoxing the chemicals designed to kill them.

She and her colleagues at Cold Spring Harbor Laboratory are trying to find specific proteins in lung cancer cells that can be targeted as biomarkers and used as another kind of test in the early detection of the disease.

Until the biomarkers are identified, Andaz said, CT scanning remains the critical screening tool. He and his colleague Dr. Stewart Fox said there are no limits to the number of people who can enroll in their research project as long as they have a 20-year smoking history and are at least age 50.

"The risk of developing lung cancer is directly affected by how much a person smokes, and for how long they have smoked," Andaz said.

Laurie Fenton Ambrose, president of the Lung Cancer Alliance, a national advocacy organization in Washington, D.C., emphasized that screening not only saves lives, but also adds a powerful new dimension to the prevention of lung cancer.

"Now we can stand along other cancers such as breast cancer, colon cancer and cervical cancer, which all have screening methods. Now we can be part of that dialogue," Ambrose said Monday, adding that the emphasis by some critics on false positives has been overstated.