Are follow-up chest x-rays after pneumonia necessary to check for lung cancer?
People 50 years of age and older who have had pneumonia are recommended to have a follow-up chest x-ray to check for lung cancer. This recommendation is based on a study of 3,398 patients who were hospitalized or seen in the emergency room for pneumonia in Edmonton, Alberta, Canada, between 2000 and 2002.
According to a summary published in JournalWatch, the study found the newly diagnosed lung cancer incidence after 90 days to be 1.1 percent, with only 40 percent of the patients having chest x-rays within 90 days. At one year, the incidence was 1.7 percent.
A total of 57 patients were diagnosed with lung cancer within one year. Of that number, only one was younger than 50. Another summary of the study points out that 79 of the patients in the study were diagnosed with lung cancer at five years. However, only 76 of the 79 patients were over 50 years old.
This study does not clearly define that routine chest x-rays after pneumonia have no benefit. Fewer than half of the patients had the x-rays, and the study was not randomized to compare the effects of imaging and non-imaging. However, because so few patients under age 50 were found to have lung cancer by means of chest x-ray, the study authors believe follow-up chest x-rays should only be given to people over 50.
But what’s the harm in people under 50 having a chest x-ray? Is it not just one more precaution against a disease that kills about 85 percent of the people within five years who contract it?
It is possible that smokers under age 50 could benefit from a chest x-ray after pneumonia, although the evidence does not necessarily point in that direction. On the other hand, there is some risk involved in having chest x-rays. There is the potential for exposing people to unnecessary radiation, which is itself a cancer risk.
So what should people at higher risk for lung cancer, no matter what their age, do? One option is to find other early detection methods that reduce the radiation risk but keep the benefits of finding lung cancer before it has had a chance to grow and spread.
Another imaging tool – the low-dose computerized tomography (CT) scan – in conjunction with a simple blood test called EarlyCDT-Lung™, shows great promise in helping physicians with the early detection of lung cancer. With early detection, lung cancer can be identified before symptoms such as pneumonia or other lung ailments show themselves. Too often, lung cancer found after symptoms appear has progressed to the point where successful treatment and survival beyond five years are unlikely.
The bottom line is that people at higher risk for lung cancer have options for life-saving early detection available to them. There is no reason to wait until pneumonia, pain or other symptoms send them to the emergency room to seek testing.
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.