Study: Lung cancer deaths reduced 20 percent by CT scans

Deaths from lung cancer can be dramatically reduced if current and former smokers undergo annual CT scans, medical investigators have found in landmark research that proves screening for the disease saves lives.

A national study of more than 53,000 people who once smoked or still do heavily found 20 percent fewer deaths occurred among those who received screening, known as helical computed tomography - or CT scanning - than among those who had standard chest X-rays.

The finding, announced Thursday by the National Cancer Institute, is considered so significant that Dr. Harold Varmus, head of the institute, halted the National Lung Screening Trial to enable any current or former smoker to take advantage of screening.

"This large and well-designed study used rigorous scientific methods to test ways to prevent death from lung cancer by screening patients at especially high risk," Varmus said in a statement Thursday. "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."

Until Thursday, there was no formally recognized method of lung cancer screening. The disease kills about 160,000 annually - more than die from breast, prostate and colorectal cancers combined.

"This is unbelievable. It's really exciting," said Dr. Shahriyour Andaz, director of thoracic oncology at South Nassau Communities Hospital in Oceanside, who for the past several years has overseen Long Island's portion of the national study.

"We were still enrolling patients, but I don't know if we need to do that anymore," said Andaz, recounting how publicity at one point during the trial forced his hospital to field phone calls from Long Islanders clamoring to join the study.

Andaz said that without screening, about 85 percent of lung cancers are usually found at a stage too advanced for life-sparing treatment.

"This is a historic day," said Dr. Nasser Altorki, chief of thoracic surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center in Manhattan, where the notion of using CT scans as a lung cancer screening tool was first advanced. He said the technique also detects benign lung nodules in smokers and former smokers, but doctors with a trained eye can discern cancers from other types of growths.

For Dr. Claudia Henschke, the Manhattan doctor who first theorized - and proved - CT scanning saves lives, the new research is vindication of her findings, reported in the British medical journal Lancet in 1999.

"I am thrilled," Henschke, now a radiologist at Mt. Sinai Medical Center, said Thursday. "This is what we have been saying all along: CT scans can save lives, and now it can be much easier to save those lives."

Dr. W. Michael Alberts, who chairs the panel on lung cancer guidelines for the American College of Chest Physicians, said the group, which previously dissuaded doctors from using the technique proactively for lung cancer screening, will have to re-evaluate its rules.

In the study, patients were followed for up to five years after enrollment in 2002. There were 354 lung cancer deaths among those who received CT scans and 442 lung cancer deaths among those who got conventional X-rays. Participants were required to have smoked a pack a day for 30 years and not have any signs, symptoms or history of lung cancer.

Gini Otway, 71, of Manhattan, said she wouldn't be alive today if she had not joined the national study in 2001. "In September I got involved . . . and in October they discovered I had a stage 1-A tumor," Otway said. A smoker since age 14, Otway said she'd gotten a CT scan annually ever since.