SPRING 2011 - Baptist Health South Florida

Senior{Focus
CT screening cuts lung cancer deaths
Former or current smokers should take note of a recent study
that found that those who were screened annually with lowdose
spiral CT (computed tomography) scans had a 20 percent
lower risk of dying from lung cancer than those screened
with conventional chest X-rays.
The results of the study were so compelling that the landmark
National Lung Screening Trial (NLST) was stopped and the preliminary
results reported.
“These findings are significant since it appears that yearly
screening with low-dose CT imaging can save lives of seemingly
healthy people who have a history of
heavy smoking,” said Baptist Hospital
Chief of Radiology Jack Ziffer, M.D., Ph.D.
“Reducing lung cancer mortality by 20
percent will make a huge difference in
sparing patients and their families from
the devastation caused by this disease.”
The National Cancer Institute, sponsor
of the study, estimates that more than
94 million current and former smokers
in the United States are at high risk for
Jack Ziffer, M.D.,Ph.D.
lung cancer. In 2010, an estimated
222,520 people were diagnosed with, and 157,300 died of, cancer
of the lung and bronchus. Cigarette smoking is the most important
risk factor, though lung cancer strikes some nonsmokers.
Chest X-rays have long been used by doctors to look for signs
of lung cancer in those patients with symptoms. But chest X-ray
screening hasn’t reduced lung cancer deaths.
Because CT can pick up much smaller tumors than X-rays, the
newer technology has been proposed as a life-saving screening
tool. Researchers wanted to find out if finding tumors earlier with
CT would increase the odds of surviving lung cancer.
The NLST, launched in 2002, focused on 53,454 former and
current heavy smokers ages 55 to 74. Participants had smoked at
least 30 “pack years” — one pack a day for 30 years, two packs a day
for 15 years, or three packs a day for at least 10 years. Former smokers
were included if they were 30 pack-year smokers who had
Compared to a one-way view of the lungs from the front or side
in a conventional chest X-ray (left), a low-dose CT lung scan gives
cross-sectional images from many different directions that can
be manipulated by radiologists for a more detailed analysis.
stopped smoking within the previous 15 years.
Participants at 33 American sites were randomly assigned to
undergo either annual screening with CT scans or traditional
chest X-rays for three years. After the three rounds of screening,
the participants were to be followed for five years.
There were 354 deaths in the CT group and 442 in the chest
X-ray group. Of those screened with CT, 24 percent had a positive
finding for an abnormality, compared to nearly 7 percent of those
screened with X-ray. Follow-up tests, such as invasive biopsies,
found no signs of cancer in the majority of those people whose CT
or X-ray results indicated a possible abnormality.
“This study only looked at current and past heavy smokers —
those at highest risk for developing lung cancer,” Dr. Ziffer said.
“The results of this trial will be used to develop national screening
guidelines that will weigh the potential for saving lives against the
disadvantages associated with the high rate of false-positive findings,
and concerns for the cumulative effects of radiation from
multiple CT scans — though the dose used for screening is much
less than that used for diagnostic imaging.”
Experts agree that the best way to prevent lung cancer is to never
start smoking, or if already smoking, to quit. If you are concerned
about your risk for lung cancer, talk to your doctor. — Anne Streeter
HOW TO GET A LUNG, HEART SCREENING
If you are at risk for lung disease or a heart attack, you may benefit from one or both of the following CT screening scans:
• CT lung screening scans look for early signs of lung cancer and other abnormalities (see story above).
• CT calcium scoring scans measure the buildup of calcium on the walls of coronary arteries, a sign of heart disease and
potential heart attacks.
Talk to your doctor about the benefits of these tests if you are over age 40; if you have diabetes, high blood pressure or high
cholesterol, or have ever smoked; or if you have a family history of heart disease or lung cancer.
A doctor’s prescription is required to schedule CT scans. If you need a physician, call Baptist Health’s free Physician Referral
Service at 786-596-6557 in Miami-Dade or 954-837-1200 in Broward. To schedule an appointment, call 786-573-6000 in Miami-
Dade or 954-837-1000 in Broward.
The cost of a CT calcium scoring scan is $120; $250 for CT lung screening. If both tests are done on the same day, the total
cost is $295. Insurance does not typically cover the cost of these tests.
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