The disadvantage of Cancer Study rented CT

lung scans are really ready for prime time?
News lung CT scans that annual risk of death from lung cancer among former and current heavy smokers was reduced to the celebration of national health officials this month. A large government study found the screening scans a person's life for all 300 smokers or former smokers who have been saved scan.
But now, cancer screening and experts are concerned that limited knowledge of private testing centers will be used to promote the testing of a large group, as has been studied. This could well lead to unnecessary lung scans, causing excessive exposure to radiation and unnecessary biopsies and surgery.
Dr. Otis W. Brawley, medical director of the American Cancer Society, said he was surprised to hear a radio advertisement for a screening center in Atlanta, the study, a few days after the government announced the results. The text of the announcement seems to be the subject of a large group of heavy smokers, women who had never smoked, said Dr. Brawley.
"We have damage to the screening will prevail," he said. "The scientific community has time to digest this. For a process that is people at high risk of lung cancer and to extrapolate and say that's good for people with medium or low risk is not appropriate. "
The study, called the National Lung Screening Trial, is focused on certain high-risk groups: 53,000 current and former smokers aged 55 to 74, had smoked for at least 30 pack-years of self. This means that if someone who smokes a pack a day for 30 years, two packs a day for 15 years, or three packs a day for at least 10 years eligible for the study.
Former smokers who have accumulated 30 years units were included only if they have quit smoking within the past 15 years.
Smokers and former smokers were either annual or CT of the lung, where X-rays of the chest. Compared to X-rays, CT or CT, scans to create a detailed three-dimensional image of the lung. The study was stopped when it became clear that the analysis group at risk of dying by 20 percent lower lung cancer than those who had protected with X-rays
But the early results also showed another facet of the analysis: one in four lung scans showed an abnormality that led in many cases additional care, exposure to radiation follow-up examinations and, occasionally, lung biopsies or even surgery at risk. But because the study was closed prematurely, a comprehensive analysis of damage by screening tests still months away.
The reading of the analysis is difficult because of the benign nodules can be mistaken for suspicious lesions. In the study, even experienced radiologists in major cancer centers have a high rate of false positives, suggesting that the rate would be even higher in the real world.
"This is a process of learning to read the spiral CT," Dr. Brawley said. "I fear that some radiologists were at the beginning of the learning curve and some patients because it can be damaged."
During the study, an advantage for scanning a particular group of smokers at high risk, this does not mean other groups will be found entitled to the same benefits, said Dr. Peter B. Bach, a lung specialist at Memorial Sloan-Kettering Cancer Center in New York. In low-risk groups, for example, it is likely that thousands of people the risks of screening would have only one life was saved will be suspended. And it is possible that many are severely damaged unnecessarily scanned.
"The sum of all the lives that have been recorded should not be considered harmful," said Dr. Bach. "Even in these very controlled about 1 percent of the population of a transaction or part of its lung removed something they thought of cancer and it was not. "
Low-dose CT expose patients to about the same radiation than mammograms.
For now, most consumers who want a review, you must pay for itself, but it is expected that the insurance company finally approved for scanning in high-risk groups. (Medicare officials said they again soon pay for testing). The government has estimated the cost at about $ 300 a scan, but some may require $ 1,000 or more.
The day the government announced the results of the study, West Side Medical Imaging in Beverly Hills, California, in a press release saying that the study "should once and for all resolve the controversy" over whether CT lung to save lives of an investigation.
In the statement, "said Dr. Norman E. Lepor scans were classified as "essential" to the annual review for patients who have smoked for 10 years.
In an interview, Dr. Lepor said he only deals with analysis of the lung for people at high risk, and he turns away people who are at low risk, but you want to scan anyway, because " they just want to know. "
Dr. Lepor said it would be "unwise" not to accept data from recent studies on the practice immediately.
"There are people who say with good conscience, and their acquisition of data, it is not ready for prime time, and there's people see the same data and reach different conclusions," said Dr. Lepor said. "This is not the first study that screening has supported. We know from our own stories, we have saved many lives. "
Dr. Lepor said he had only one woman who had smoked for 50 years and appeared on their risks. "She is the poster for this test," he said.
Mr Brawley said he feared that some early press releases and radio is just the beginning of a broad support from lung scans screening.
"It was kind of threat action Sunday night in my home office and the thing comes on the radio," he said. "Many people go when a new ad and get the new test. We are afraid that some those arising because of these disadvantages.