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Senior Citizen Health & Medicine
CT Screening May Save Millions from Deadly Lung
Cancer
Study finds 85% detection
that can increase
10-year survival by 92%
October 25, 2006 – There is new hope for senior
citizens and others at highest risk for the deadliest cancer. Lung
cancer can be detected at its very earliest stage in 85 percent of
patients using annual low-dose CT screening, and when followed by prompt
surgical removal, the 10-year survival rate is 92 percent. These
results, to be reported tomorrow in the New England Journal of Medicine,
would dramatically decrease the number of deaths from lung cancer -- the
number one cause of cancer deaths among both men and women in the U.S.
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The study was launched by a team of researchers at
New York-Presbyterian Hospital/Weill Cornell Medical Center in 1993 and
has expanded into an international collaboration of 38 institutions in 7
countries, the International Early Lung Cancer Action Project (I-ELCAP).
The I-ELCAP study is the largest, long-term study to determine the
usefulness of annual screening by CT.
Stage I lung cancer is the only stage at which cure
by surgery is highly likely. While survival rates have been climbing for
other forms of cancer, the survival rates for lung cancer have remained
dismal. Approximately 95 percent of the 173,000 people diagnosed each
year die from the disease -- more than breast, prostate and colon cancer
combined. The high death rates are a consequence of lung cancer not
being detected early enough for treatment to be curative.
Among the 31,567 people in the study, CT screening
detected 484 people who were diagnosed with lung cancer, 412 of whom
were Stage I. Of the Stage I patients who chose not to be treated, all
died within five years. Overall, the estimated 10-year survival rate for
the 484 participants with lung cancer was 80 percent.
The participants were 40 years of age and older and
at risk for lung cancer because of a history of cigarette smoking,
occupational exposure (to asbestos, beryllium, uranium or radon), or
exposure to secondhand smoke.
"We believe this study provides compelling evidence
that CT screening for lung cancer offers new hope for millions of people
at risk for this disease and could dramatically reverse lung cancer
death rates," said Dr. Claudia Henschke, the study's lead author and
principal investigator who is chief of the chest imaging division at
NewYork-Presbyterian/Weill Cornell and professor of radiology and
cardiothoracic surgery at Weill Cornell Medical College.
Since the early 1990s, there have been remarkable
advances in CT scanners. Sub-millimeter "slicing" can now be applied to
the entire chest in a single breath-hold. As a result, lung cancer may
be detected when it is smaller than it was possible to diagnose
previously.
Although CT scans once yielded only 30 images,
current technology yields over 600 images. As the technology advanced,
the approaches for studying the usefulness of this technology have also
advanced.
The charge for a low-dose CT screening varies, but
ranges from $200 to $300. Treatment for Stage I lung cancer is less than
half the cost of late-stage treatment. Estimates of the
cost-effectiveness of CT screening for lung cancer are similar or better
than those for mammography screening for breast cancer.
One of the problems, however, is that these
screenings are not covered by Medicare or most other insurance. Many
experts recommend patients who feel they are at high risk, such as
long-time smokers, should talk with their doctor about these screenings
programs.
Members of the study's writing committee were New
York-Presbyterian/Weill Cornell's Drs. David F. Yankelevitz (attending
radiologist and professor of radiology and cardiothoracic surgery at
Weill Cornell Medical College), Daniel Libby (attending pulmonologist
and professor of pulmonary and critical care medicine at Weill Cornell),
James P. Smith (attending pulmonologist and professor of pulmonary and
critical care medicine), Mark Pasmantier (attending oncologist and
professor of medicine), and Olli S. Miettinen (epidemiologist and
professor of medicine).
Also contributing to the study at New
York-Presbyterian/Weill Cornell were Drs. Nasser Altorki (director of
thoracic surgery and professor of cardiothoracic surgery at Weill
Cornell Medical College), Dorothy I. McCauley (attending radiologist and
professor of radiology at Weill Cornell), Madeline Vazquez (attending
pathologist and professor of pathology), Ali Farooqi (radiology fellow),
and at Cornell University in Ithaca, Anthony Reeves (professor of
electrical and computer engineering).
Additionally, physician-scientists from New
York-Presbyterian Hospital/Columbia University Medical Center
participated in the current study: Dr. John H.M. Austin (attending
radiologist and professor of radiology at Columbia University College of
Physicians and Surgeons) and Dr. Gregory D.N. Pearson (associate
attending radiologist and associate professor of radiology at Columbia
University College of Physicians and Surgeons).
The current study was supported by numerous private
and public grants, including a grant from the National Institutes of
Health (NIH).
Editor's Notes:
About NewYork-Presbyterian Hospital/Weill Cornell
Medical Center
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in
New York City, is one of the leading academic medical centers in the
world, comprising the teaching hospital NewYork-Presbyterian and its
academic partner, Weill Cornell Medical College. NewYork-Presbyterian/Weill
Cornell provides state-of-the-art inpatient, ambulatory and preventive
care in all areas of medicine, and is committed to excellence in patient
care, research, education and community service. NewYork-Presbyterian is
ranked sixth on the U.S. News & World Report's list of top hospitals.
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