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CT scans lead to early diagnosis of lung cancer
Cancer now state's leading cause of death
Dr. Paul Walker
(Nov. 11, 2010)
Advanced imaging techniques offer a way to catch lung cancer – as well as other diseases – at their earliest stages when the chance for a cure is greatest, according to a federal study and specialists at East Carolina University.
The findings, released last week by the National Cancer Institute, said annual screening for lung cancer with low-dose computed tomagraphy scans cut mortality rates in older, current or former heavy smokers by 20 percent.
The findings coincide with figures released Tuesday showing cancer has become the leading cause of death in North Carolina, taking approximately 17,500 lives in 2009, a few hundred more than heart disease. Lung cancer was the leading deadly cancer.
"This is a huge advance and step forward in the curing of lung cancer," said Dr. Paul Walker, a lung cancer specialist at the Brody School of Medicine at ECU. "It has been known that chest X-ray screening detected earlier stage lung cancers than waiting until symptoms develop. It has been known that CT screening is much better than a chest X-ray in identifying small lung cancers. "However, scientists and statisticians have argued that until and unless there was a study showing a mortality benefit of lung cancer screening, just the early stage detection was not scientific and statistical proof of a lung cancer screening benefit. That is now here."
As an added benefit, annual CT screening also cut deaths from any cause by 7 percent, according to the $250 million National Lung Screening Trial. The results, published in the Nov. 4 issue of Radiology, were significant enough to trigger an early halt to the trial once the benefits of the scans became clear.
The CT scans are available at ECU as well as its teaching hospital, Pitt County Memorial Hospital. Scans are painless and require only a single breath hold, Walker said. Even CT scans for other reasons sometimes turn up tumors.
"One of the eight new lung cancer patients from our thoracic oncology clinic last Thursday afternoon was diagnosed with an incidental chest CT because of going to the (emergency department) with choking on a pill, and a small lung tumor was identified," Walker said.
With the study results in hand, Walker said the biggest issues now are to better identify who needs the screening and how to handle the number of benign nodules that can be seen. Paying for the scans will also be an issue, as most insurance companies and Medicare will not reimburse for them, as will the danger to patients of added radiation exposure.
Walker said ECU physicians from various disciplines will begin working to set up guidelines for integrating CT screening into the lung cancer care they provide.
November is Lung Cancer Awareness Month. ECU will host a free lung cancer awareness event Tuesday, Nov. 16, at the Greenville Hilton beginning at 5:30 p.m. Call 744-1789 for more information or to register.