Results of the National Lung Screening Trial (NLST), published today in the New England Journal of Medicine, showed that lung cancer deaths fell by 20% and all-cause mortality fell by 7% when heavy smokers were screened regularly using low-dose spiral computed tomography (CT) compared with standard chest x-ray. The NLST study followed more than 53,000 current and former smokers ages 55-74.
“Lung cancer is the leading cause of cancer death in the world and there has been no effective means of early detection, which is critical to improving outcome because surgery can cure early-stage disease but there are no curative therapies for advanced disease,” said Paul A. Bunn, Jr., M.D. Executive Director of the International Association for the Study of Lung Cancer (IASLC). Bunn holds the James Dudley Chair in Cancer Research at the University of Colorado School of Medicine, Division of Medical Oncology.
Experts from around the world will gather in Amsterdam on July 2-3 for an invitation-only Lung Cancer CT Screening Workshop prior to the start of the 14th World Conference on Lung Cancer (WCLC). IASLC will host the WCLC in Amsterdam from July 3-7. Topics to be discussed at the workshop include recommendations for CT screening implementation and the appropriate workup for screen-detected lung cancers.
A major turning point
“The publication of the NLST trial is a major turning point in lung cancer, which demonstrates the enormous potential of CT screening as an early detection tool, which, in combination with smoking cessation programs, is likely to have a major impact on lung cancer,” said Professor John K. Field, MA, Ph.D., BDS FRCPath, who chairs IASLC’s CT Screening Task Force. Field is director of research at the Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine at The University of Liverpool.
Clinical management outcomes
Although the NLST results are encouraging, other important trials are under way that will provide critical additional information not only on mortality advantage and cost effectiveness, but also on the clinical management outcomes of lung cancer screening. Different nations will require varying levels of evidence to support the decision to provide national lung cancer screening services.
“It is important to realize that enthusiasm for routine use of these scans should be limited to the population studied — 30 pack years of smoking and age 55-74 — and that many issues remain unresolved,” Dr. Bunn said. “Among these are the cost-effectiveness of the procedure and the best way to follow small nodules that may or may not be cancer.?
For more information:
– Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. The National Lung Screening Trial Research Team. June 29, 2011 (10.1056/NEJMoa1102873)
– National Lung Screening Trial (NLST)[NCT00047385]