Often, patients with lung cancer are diagnosed in much later stages, but now 2 large randomized clinical trials have shown that low-dose computed tomography (CT) scans can help catch the cancer earlier on, according to Taofeek Owonikoko, MD, PhD, MSCR.
“The National Lung Screening Trial (NLST) established the basis for screening for patients 55 years of age to 80 years of age, those who have a 30 pack-year history of smoking and continue to smoke, as well as those who stopped smoking within the last 15 years,” said Owonikoko, co-chair of the Clinical and Translational Review Committee, and professor, Department of Hematology and Medical Oncology, at Winship Cancer Institute of Emory University, in an interview with Oncology Nursing News’ sister publication OncLive.
From the NLST trial, there was a 20% reduction in lung cancer mortality in the individuals who participated in annual screenings over 3 years with low-dose CT. The second randomized trial to echo these results, the NELSON trial, showed that men who had CT screenings at years 1, ,2, 4, and 6.5 had a 26% reduction in their risk of lung cancer mortality, whereas women saw a reduction at a larger magnitude, said Owonikoko. Among the women in this trial there was a 39% reduction in their risk of lung cancer mortality by year 10. According to Owonikoko, this difference in results may have something to do with the biological differences in lung cancer between men and women.
The NLST trial, which was considered the most impactful study according to Owonikoko, enrolled over 50,000 patients considered to be at high risk of developing lung cancer 55 years of age or older and had a 30 pack-year smoking history. The study then randomized these patients to either a chest X-ray or a low-dose CT screening, the later was found to more effective.
“We learned that we could diagnose lung cancer at much earlier stages with the use of low-dose CT screening. Half of all cases diagnosed with low-dose CT screening were stage IA or IB, which are surgically curable. Conversely, 50% of patients who were screened with chest X-ray alone had stage IIIB or IV disease. [Confirming] our early observation that chest X-ray is not an effective way of screening patients,” said Owonikoko.
Among the benefits of being able to screen for lung cancer early, having patients come in for these CT scans allows for practitioners to encourage their patients to stop smoking. This counseling on smoking cessation is just as important as it will reduce their risk to develop lung cancer entirely.