December 31, 2013
Health Experts Urge Older, Heavy Smokers To Get Annual CT Scan
Brett Smith for redOrbit.com - Your Universe Online
An independent panel of American health experts has issued a report, published in the Annals of Internal Medicine, that recommends people between the ages of 55 and 80 years old who are at high risk for lung cancer should have an annual low-dose CT scan to detect any evidence of the disease.
The US Preventive Services Task Force identified “high risk” individuals as current or former smokers who smoked the equivalent of a pack per day for 30 years. A former smoker was not considered high risk if they had quit at least 15 years ago. The USPSTF also recommended that high risk individuals not be scanned if they’re too sick to withstand cancer treatment.
“It’s clear that the longer and the more a person smokes, the greater their risk is for developing lung cancer,” said Dr. Michael LeFevre, co-chair of the task force in a statement. “When clinicians are determining who would most benefit from screening, they need to look at a person’s age, overall health, how much the person has smoked, and whether the person is still smoking or how many years it has been since the person quit.”
LeFevre told the Associated Press that the panel’s recommendation could prevent as many as 20,000 deaths a year. However, the doctor cautioned against current or former smokers overreacting to the task force’s recommendations for a narrow slice of the population.
“We could see more harm than good," LeFevre said about screening too many people. "There's a lot of room for what I would call people exploiting the recommendation. I can imagine a street-corner imaging center advertising to invite people in."
Task force members said they made the narrow recommendations because of limited evidence showing that lighter smokers would benefit from the screenings, as CT imaging does expose the body to radiation.
“The benefit of screening may be significantly less in people with serious medical problems and there is no benefit in screening someone for whom treatment is not an option,” said Dr. Virginia Moyer, the task force chairperson. “In these people, screening may lead to unintended harms such as unnecessary tests and invasive procedures.”
“Screening for lung cancer, while beneficial, should not be an alternative to quitting smoking,” she added. “The best way to reduce the sickness and death associated with lung cancer is to promote smoking cessation and protect people who are non-smokers from tobacco smoke exposure.”
The task force, which is an independent volunteer panel of experts, said the results from the National Cancer Institute's 2011 National Lung Screening Trial played a major role in the recommendations. The study, which included over 53,000 smokers across the United States, found that annual low-dose CT imaging could avert 20 percent of lung cancer deaths. The panel had proposed the screenings last year, but the final recommendations weren’t published until Monday.
In an editorial published alongside the new recommendations, a pair of cancer experts expressed concerns over effectively reducing the lung cancer rate.
“Effective implementation of lung cancer screening hinges on reaching high-risk individuals; studies show that those at higher risk (smokers) are less interested in being screened despite recognizing that they are at risk,” the researchers wrote. “Another issue, as seen in studies of adherence to colon cancer screening, is whether we can achieve adequate adherence and follow-up in persons who are at highest risk for lung cancer.”