November 1, 2006—A report in the October 26 issue of the New England Journal of Medicine shows the results of a large collaborative study on the efficacy of screening for lung cancer with CT. Scans were given to 31,567 asymptomatic high-risk patients over the age of 40. Lung cancer was found in 1.5% (484) of the participants; eighty-five percent of these had clinical stage I lung cancer.
The patients were subsequently treated, and after 10 years 88% were alive. Had the patients’ cancers progressed unchecked, the survival rate would have dropped dramatically; an editorial accompanying the study notes that the 5-year survival rate for patients diagnosed with stage IV lung cancer is about 5%.
The cost-effectiveness of this method, which the researchers compare to screening mammograms, remains undetermined. Though CT scans are costly, catching lung cancer early reduces the financial burden associated with treating late-stage patients.
Critics of the study note that it was case-controlled, not a clinical trial, and lacks a control group for comparison. The survival rate was also augmented, in all likelihood, by the prompt resection treatment stage I patients received. The 8 stage I participants who opted not to receive treatment died within 5 years.