Screening for Lung Cancer

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.






Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.

In the past, no lung cancer screening test had been shown to lower the risk of dying from this disease. Studies involving spiral CT (or helical CT) have shown some promise in finding early lung cancers in heavy smokers and former smokers. So far, major medical groups have not recommended routine screening tests for all people or even for people at increased risk, such as smokers.

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National Lung Screening Trial Aims to Detect Lung Cancer Earlier

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference. You can view all the presentations from the conference here. In this blog, she discusses a presentation from Drew Torigian, MD, MA, about the National Lung Screening Trial, which compared cancer screens to detect lung cancer early.

Experts agree that if cancer is detected early, a patient has a better chance of recovery. The goal of detecting lung cancer early, however, has been elusive. 

Study after study has shown that standard chest X-rays do not detect early lung cancers. This is true even when X-rays are given on a regular basis to those at high risk for developing lung cancer. 

So how can lung cancer be caught earlier? And how can lung cancer deaths be prevented?

Lung cancer remains the second most common cancer in this country and the most common cause of cancer deaths. Additionally, lung cancer rates continue to rise in many countries around the world.


CT Scans for Lung Cancer
Computed tomography (CT) scans for cancer are more sensitive in finding lung abnormalities, and better able to detect more and smaller lesions. CT scans are, however, a more expensive technology than chest X-rays. They can also be non-specific in determining if abnormalities are lung cancers are benign nodules. 

The National Lung Screening Trial (NLST) compared two ways of detecting lung cancer in high-risk smokers: low-dose helical computed tomography (CT) and standard chest X-ray.

The study aimed to find it is possible to detect lung cancers at an earlier, more treatable stage, and whether such screening would decrease cancer deaths.  

Drew Torigian, MD, MA, associate professor of radiology at the Perelman School of Medicine at the University of Pennsylvania, served as principle investigator at Penn for this national study, which involved more than 53,000 patients in 33 different sites. He described the results of this trial, the largest, most expensive randomized screening trial ever conducted, at the Abramson Cancer Center’s 2011 CANPrevent Lung Cancer Conference.

All clinical trials have a specific primary endpoint or goal by which success is measured. For the NLST, that goal was to determine if low dose CT screening could reduce the death rate from lung cancer among heavy smokers. Patients enrolled in the trial were current or past heavy smokers between the ages of 55 and 74. Half received regular chest X-rays while the other half received helical CT scans over a period of three years.

The results were encouraging.

CT scanning detected significantly more cancerous and pre-cancerous lesions than chest X-rays. However, finding lesions isn't enough. The study had to demonstrate early detection actually saved lives.Preliminary results of the study showed 87 more lives were spared by helical CT as compared to chest X-rays, which translates into a 20 percent reduction in the death rate.

While the NLST results are positive, Dr. Torigian points out there are many questions that still need to be addressed and answered before low-dose, helical CT scanning can be considered a standard screening procedure. Many of these questions relate to the overall costs and cost-effectiveness of implementing CT scanning programs, such as:

• Who should be get a cancer screen?
• How often should they be scanned?
• At what age should screening begin?
• Will insurance cover helical CT scanning?
• How many screenings are needed?
• What is the impact, both in cost and on the health of the participants of the high rate of false positives (non-cancerous, and generally non-clinically important lesions) found in CT screening?
• Are there biomarkers that will allow better targeting of populations that will benefit from this type of screening?

There are social policy questions as well, including the impact of undergoing CT screening on smoking behavior. Does the screening encourage people to quit, or give them a false sense of security?

Dr. Torigian stressed the unanswered questions do not detract from the importance of finding better ways to detect early lung cancers. Lung cancer is a global epidemic, and finding more early stage cancers will lead to better outcomes in treating lung cancer.

Watch all the presentations from the 2011 CANPrevent Lung Cancer Conference here.

Learn more about lung cancer treatment at the Abramson Cancer Center.

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Proton Therapy for Lung Cancer Patients at Penn

Proton therapy is external beam radiotherapy in which protons are directed at a tumor. The radiation dose that is given through protons is very precise, and limits the exposure of normal tissues. This allows the radiation dose delivered to the tumor to be increased beyond conventional radiation doses. The result is a better chance for curing cancer with fewer harmful side effects.

Unlike X-rays, protons can be manipulated to release most of their energy only when they reach their target. With more energy reaching the cancerous cells, more damage is administered by each burst of radiation while sensitive, healthy lung tissue is better protected from the effects of radiation.

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New Scan Detects Lung Tumors Earlier Than Traditional Scans

Penn's Abramson Cancer Center is hosting a free conference about preventing lung cancer on Friday, October 14.

Register for this free conference, or follow #LungCancerACC on Twitter on Friday, October 14 for live updates from the Focus On Lung Cancer Conference.

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.

Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.

In the past, no lung cancer screening test had been shown to lower the risk of dying from this disease. Studies involving spiral CT (or helical CT) have shown some promise in finding early lung cancers in heavy smokers and former smokers. So far, major medical groups have not recommended routine screening tests for all people or even for people at increased risk, such as smokers.

People who smoke, who smoked in the past, or who have been exposed to other people's smoke, as well as those who have worked around materials that increase the risk for lung cancer need to be aware of their lung cancer risk. They should talk to their doctors about their chances of getting lung cancer and the pros and cons of lung cancer screening.

For those who decide in favor of testing, the physicians in Penn Medicine’s Lung Cancer Program are experienced in lung scanning and the latest screening techniques for people at high risk.

For information about smoking cessation programs at Penn Medicine, visit PennMedicine.org/smoking or call 800-789-PENN (7366).

Join Our Lung Cancer Webchat Live from the Focus On Lung Cancer Conference
Lung cancer experts will answer questions about risk, diagnosis and treatment. Submit questions in advance, view and participate in the live webchat and read transcripts after the webchat.
Time: 12:15 PM, EST
Website: OncoLink.org/Webchat

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Should You Be Screened for Lung Cancer?

When it comes to lung cancer, the numbers are not good. More people in the U.S. die from lung cancer than any other type of cancer.

Consider these facts:

• In 2011, more than 220,000 Americans will be diagnosed with lung cancer and more than 156,000 people will die of lung or bronchus cancer.
• Smokers are 10 to 20 times more likely to get lung cancer. About 90 percent of lung cancer deaths in men and almost 80 percent of lung cancer deaths in women are due to smoking.
• There are more than 94 million current or former smokers in the U.S.
• Among both men and women in the United States, lung cancer is the second most common type of cancer, accounting for more deaths than breast cancer, prostate cancer, and colon cancer combined.

Screening uses tests or exams to find a disease like cancer in people who don't have any symptoms. Because lung cancer often spreads beyond the lungs before it causes symptoms, a screening test that finds lung cancer early could save many lives.

In the past, no lung cancer screening test had been shown to lower the risk of dying from this disease. Studies involving spiral CT (or helical CT) have shown some promise in finding early lung cancers in heavy smokers and former smokers. So far, major medical groups have not recommended routine screening tests for all people or even for people at increased risk, such as smokers.

People who smoke, who smoked in the past, or who have been exposed to other people's smoke, as well as those who have worked around materials that increase the risk for lung cancer need to be aware of their lung cancer risk. They should talk to their doctors about their chances of getting lung cancer and the pros and cons of lung cancer screening.

For those who decide in favor of testing, the physicians in Penn Medicine’s Lung Cancer Program are experienced in lung scanning and the latest screening techniques for people at high risk.

For information about smoking cessation programs at Penn Medicine, visit PennMedicine.org/smoking or call 800-789-PENN (7366).

Learn about proton therapy for lung cancer.

Read More