The Lombardi Cancer Center will be one of 30 participants in a U.S. study with the National Cancer Institute to find a more effective way to reduce lung cancer deaths. The National Lung Screening Test, which begins this year and ends in 2009, will compare the effectiveness of chest X-rays versus spiral Computerized Tomography in reducing lung cancer deaths.
According to its proponents, the results of the NLST will be significant for smokers and others at risk for lung cancer in Washington, D.C.
“Lung cancer kills more than cancers of the breast, prostate, colon and pancreas combined, and it will claim nearly 155,000 lives this year – 300 of them in the District of Columbia alone,” Principal Investigator of NLST at the Georgetown site and professor of oncology Edward Gelmann said.
Both chest X-rays and spiral CTs are ways of screening the lungs for tumors. The spiral CT may prove to be more effective as it can detect tumors smaller than one centimeter, while X-rays can only detect tumors between one and two centimeters.
“NLST is important because there are more than 90 million current and former smokers in the United States at high risk for lung cancer, and rates for this disease, unlike many other cancers, have not declined,” Director of Cancer Prevention for the NCI and co-director of NLST John Gohogan said.
Lombardi and the 29 other participating sites will screen a total of 50,000 people. Each participant will be randomly assigned to either a chest X-ray or a spiral CT once a year for three years. Each will also have yearly health exams until 2009. Participants must be either current or former smokers between the ages of 55 and 74 who have not had cancer within the last five years.
The spiral CT is currently used by more than half of U.S. hospitals to determine how advanced a patient’s cancer is after he or she has already been diagnosed; many have begun to use it for pre-diagnosis. The spiral CT uses chest X-rays in order to scan the lungs while the participant holds his or her breath. The scanner rotates and creates a three-dimensional model of the patient’s lungs on a computer screen.
There is also the possibility that either test could detect non-cancerous lesions that would lead to unnecessary diagnostic tests, as well as risky procedures to remove them. The study will determine whether the aggregate harm from performing screening tests is outweighed by the potential benefit of reduced mortality from lung cancer.
“If the spiral CT is effective, it could be the only medical intervention that will impact lung cancer mortality rates. No test yet has been shown to impact cancer mortality,” Gelmann said.
In fact, the only thing that has a large impact upon lung-cancer mortality rates is refraining from smoking, he said.
“Our hope is that this study will lead to saving lives,” Gelmann said.
