Lung Cancer Screening: You read it here first.

Not exactly. But, BHN writer Tinker Ready reported on the research and controversy surrounding the approach in a freelance story for the Boston Globe in 2000.

 Yesterday’s news that spiral CT screening reduces the death rate for heavy smokers is a vindication of sorts for patient advocates and researchers at Cornell who championed it.  

The Globe’s Stephen Smith wrote it up for this morning’s paper.  He seems to have hit all the cautionary notes while  not minimizing the benefits.

Screening heavy smokers with sophisticated medical scanners modestly reduced their chance of dying from lung cancer, according to a federal study released yesterday that provides the first convincing evidence that testing could reduce the toll from the leading cause of cancer deaths.

Over at Health News Review, they would have preferred that journalists report on the absolute difference in deaths over the 20 percent relative difference in lung cancer death rates…In commenting on the NYTimes story, reviewers argue “that the absolute difference in death rates was much less than one percent, because of the small number of few lung cancer deaths in either the CT (354 or 1.32%) or x-ray (442 or 1.65%) group compared to the size of the total trial population (about 53,500).”

 Not an easy concept to explain to Joe and Josephine Six-pack, but important nonetheless. Sometimes it just helps to use the raw numbers.  

We also note that, despite the findings, the doubtful and cautious in the 2000 story remain skeptical:

Globe 2000Edward Patz, a professor of radiology at Duke University Medical Center in Durham, N.C., said that, until that study is complete, he fears the test may be offering patients false hope.
    Without data from a larger study, he said, no one knows whether the scans are adding years to patients’ lives or just getting them in for surgery a bit earlier.
    “No way we’ll be doing it,” Patz said. “It’s medically irresponsible.”   

NYTimes 2010: But Dr. Edward F. Patz Jr., professor of radiology at Duke who helped devise the study, said he was far from convinced that a thorough analysis would show that widespread CT screening would prove beneficial in preventing most lung cancer deaths. Dr. Patz said that the biology of lung cancer has long suggested that the size of cancerous lung tumors tells little about the stage of the disease.

“If we look at this study carefully, we may suggest that there is some benefit in high-risk individuals, but I’m not there yet,” Dr. Patz said.

Mass General 2000: Amid the conflicting scientific advice and rising patient demand, some Boston hospitals have tried to navigate a middle course, offering CT scans, but unlike free-standing clinics in other states that promote the test, they accept only patients referred by doctors.
    Theresa McCloud, the director of Thoracic Radiology at Mass. General (said)… without it, she can offer nothing but a grim prognosis to lung cancer patients.
    “It’s pretty solid evidence that this is a benefit,” she said. “It’s the only thing we have for such a horrible tumor.”

Mass General 2010: The US cancer agency stopped short of recommending that smokers undergo CT scans, a cautious approach shared by specialists not involved in the study. “The main cautionary note right now is that this study hasn’t been peer-reviewed and full data haven’t been disclosed,’’ said Dr. Lecia Sequist, a lung cancer specialist at Massachusetts General Hospital Cancer Center.


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