Chest x-rays fail to reduce lung cancer mortality. Is reliable early detection possible?
The results are in, and the message is that chest radiographs (x-rays) do not reduce the lung cancer mortality rate. This is the conclusion of a report published recently in the Journal of the American Medical Association.
The news about the ability of chest radiographs in the early detection of lung cancer supports the conclusions of randomized studies performed in the 1970s and 1980s. In the more recent study, lung cancer mortality among patients who received up to four annual chest radiographic screenings was compared with mortality among a control group that received normal care. After 13 years of follow-up, the study found no significant difference in mortality from lung cancer between the patient groups.
The true measure of a cancer early detection tool is its proven effect on the mortality rate. In the case of lung cancer, this statement is particularly significant for two reasons:
• Lung cancer causes more deaths than any other kind of cancer. It kills more people than colon, breast, kidney, liver, prostate and melanoma cancers combined. In fact, about 30 percent of cancer deaths in this country result from lung cancer.
• By the time symptoms of lung cancer appear, the disease is often far advanced and the chance of survival beyond five years when the cancer is that progressed can be as low as 5 percent.
Chest x-rays are not the only cancer detection tools in discussion of late. There was also a recent study focusing on screening with low-dose spiral computed tomography (CT) in the National Lung Screening Trial (NLST). This study, involving patients at high risk for lung cancer, found that the mortality rate from lung cancer in the CT group was reduced by 20 percent.
This begs the question: Is CT the way to go for early lung cancer detection? While the news about the mortality rate is positive, CT scans also have their drawbacks. They are expensive for patients, have a high false-positive rate and expose patients to radiation.
It is clear that early detection of lung cancer is a critical objective. Despite the relative lack of attention lung cancer receives compared to a disease like breast cancer, for example, early detection research and development are taking place.
One promising new tool, which can be used in congruence with CT scans, is a blood test called EarlyCDT®-Lung. This test, covered by Medicare and private insurance, measures the body’s immune response to lung cancer proteins to detect the presence of cancer. With greater than 90% accuracy and 7 times fewer false positives than CT, it can be used in conjunction with CT scanning to better assess lung cancer risk for high-risk patients or to help categorize indeterminate pulmonary nodules.
It appears strides are being made in early lung cancer detection. What is also needed, however, is increased awareness of the impact of the disease as well as decreased stigmatization of lung cancer patients based on the assumption that they brought the disease on themselves by smoking.
The fact is that lung cancer affects smokers, former smokers and non-smokers alike. Although smoking is the leading risk factor, it is only one of them. No one deserves cancer of any kind, and everyone deserves the opportunity to survive cancer when it strikes.
For more information on the clinical validation, as well as other peer review articles highlighting EarlyCDT-Lung, click here to access papers and publications. You may also view the video of Professor John Robertson, pioneer of the technological platform, discuss the data.
To learn more about becoming a provider of EarlyCDT-Lung, click here.