Some Lung Cancer Tumors May Be Harmless

Researchers report that the use of computed tomography (CT) scans to screen for lung cancer in smokers may lead to needless treatment in some cases.

In the study, a team including investigators from Duke University Medical Center, the National Cancer Institute, and Brown University sought to estimate overdiagnosis in the National Lung Screening Trial, a major 7-year study recently undertaken to determine whether lung CT scans could help prevent cancer deaths.

In the lung screening trial, researchers found that 20 percent of lung cancer deaths could be prevented if doctors performed CT screening on individuals from ages 55 to 79 who are current smokers or had quit smoking within the last 15 years. To qualify for screening, participants had to have smoked an average of one pack of cigarettes a day for 30 years.
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Based on those findings, the American Lung Association, the American Cancer Society, the American College of Radiology, and other medical associations recommended regular screenings for that specific segment of the smoking population.

In addition, the federal government has issued a draft that, if approved, would make lung CT scans a recommended preventive health measure that must be fully covered by insurance companies, with no co-pay or deductible.

Latest projections based on that same data, however, found more than 18 percent of the cancers detected by the scans would be unlikely to harm the patient, says Edward Patz Jr., MD, study co-author and a professor of radiology at Duke University Medical Center, who notes that more research is needed to uncover genetic markers that will allow doctors to better differentiate aggressive tumors from cancers that may not require treatment.

“These findings will not change the recommendations or treatment guidelines,” adds Patz.

“The data will be used to inform patients and practitioners of one of the risks of screening for lung cancer.”

—Mark McGraw

Reference

Patz E, Pinsky P, et al. Overdiagnosis in Low-Dose Computed Tomography Screening for Lung Cancer. JAMA Internal Medicine. 2013.