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 After 10 years, the mortality rate for men who received regular
screening was reduced by 24% compared to men who got no screening.
Although women were under-represented in the study, the research
team found that screening lowered their risk of dying from lung
cancer by 33%. A total of 15,792 people volunteered for the study.
The decline "is significant and clear-cut for males. It seems even
more effective in females," lead study author Dr. Harry de Koning of
Erasmus Medical Center in Rotterdam told Reuters Health in a
telephone interview.
The researchers estimated that four rounds of screening over about
five years prevented 60 deaths from lung cancer among the 6,583
screened. The rate of false alarms was 1.2%.
The findings buttress results from the United States, released in
2011 from the National Lung Screening Trial, showing a 20% reduction
in mortality with CT screening.
Although U.S. guidelines began endorsing routine lung cancer
screening after the release of the 2011 findings, European countries
has been slower to adopt the practice because studies done there
have been small or inconclusive.
Will the new findings change practice in Europe?
"They really should," said de Koning, a professor of public health
at Erasmus. "This is the second large trial showing it works and it
shows an even bigger effect than the first trial."
"These doubts should be laid to rest" by a new study, known as
NELSON, Stephen Duffy of Queen Mary University of London and John
Field of the University of Liverpool in the UK write in an editorial
accompanying the study in the New England Journal of Medicine.
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"Our job is no longer to assess whether low-dose CT screening for
lung cancer works: it does," they write. "Our job is to identify the
target population in which it will be acceptable and
cost-effective."
Lung cancer kills more people worldwide than any other type of
cancer. It's responsible for 18.4% of all cancer deaths, in part
because 70% of the people diagnosed with the disease are already at
an advanced stage when it's discovered. Only 15% survive for five
years.
The new findings are "going to be extremely impactful," said Dr.
Andrea McKee, who directs the CT lung cancer screening program at
the Lahey Hospital and Medical Center in Burlington, Massachusetts,
and was not involved in the study.
The NELSON trial, which looked at different screening intervals,
also found that the low-dose CT scans should be done in smokers and
former smokers once a year, de Koning said.
"Two and a half years between scans was really too long" and the
tumors that were detected were caught too late, he said.
"When you do annual screening, 88% of patients have stage 1 or 2
disease," McKee told Reuters Health in a telephone interview. "It's
incredible the number of lives we're going to save" when screening
becomes as accepted as mammography, which uses a comparable dose of
radiation to detect breast cancer.
SOURCE: https://bit.ly/2RuEVji The New England Journal of Medicine,
online January 29, 2020.
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