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Research Compares CT Scans And Chest X-Rays For Lung Cancer Screening

Lyall A. Gorenstein, MD, FRCS (C), FACS

Lyall A. Gorenstein, MD, FRCS (C), FACS

A recent study funded by the National Institutes of Health found that CT screening reduced deaths from lung cancer by 20%. While it may seem intuitive that screening would help to detect lung cancers and reduce deaths, until now, that had not been definitively proven.

“This is a landmark study,” said Lyall A. Gorenstein, MD, Director of Minimally Invasive Thoracic Surgery at NewYork-Presbyterian/Columbia University Medical Center, who lauded the study’s design and its clear implications for treating patients at risk for lung cancer. Lung cancer is the leading cause of cancer-related deaths in the United States, but the merits of screening — whether or not it actually improves patient outcomes – has been a topic of debate for the last 30 years. Dr. Gorenstein believes that controversy has now been settled: “Finally there is conclusive evidence demonstrating that CT screening in patients who are at high risk for the development of lung cancer can significantly lower mortality from the disease.”

The National Lung Screening Trial enrolled more than 53,000 people, current and former smokers, assigning half to receive low-dose CT scans and the other half to be screened by chest x-ray. After eight years the group assigned to receive CT screening had a 20% lower mortality rate than those screened by chest x-ray.

The low-dose CT (computed tomography) screening of the lungs studied in this randomized controlled trial takes from 7-15 seconds of one held breath for a scanner to rotate full circle around the body and compiles that information into images of the chest and lungs. While chest x-rays produce a single snapshot, CT produces a complete 3D image that allows doctors to view cross-sections of the entire lungs, frame-by-frame.

The Thoracic Surgery Section at NYP/Columbia uses CT screening in its High-Risk Lung Assessment Program. Some lung diseases (both cancerous and non-cancerous) that can be detected by CT may have no symptoms early in their development when treatment can be most effective. A hallmark of the High-Risk Lung Assessment Program is its proactive screening of people at high risk for lung disease—a standard that the National Lung Screening Trial has now shown to save lives.

*This blog post was originally published at Columbia University Department of Surgery Blog*


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