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Washington, D.C. — Researchers at Lombardi Cancer Center at Georgetown University Medical Center are recruiting 500 smokers and ex-smokers for a study that will examine the effectiveness of spiral computed tomography (CT) scans—a promising but unproven technology for lung-cancer screening.
The Lombardi study is part of the Lung Screening Study, a year-long, $3 million study sponsored by the National Cancer Institute (NCI). Five other screening centers across the United States also are recruiting for the study, which will involve a total of 3,000 participants. The study will not determine if the spiral CT scans save lives—the gold standard for any cancer screening test—but rather will gauge the feasibility of performing a larger, longer study designed for that goal.
"Lung cancer is the leading cause of cancer-related death in the United States, so we are eager to explore the possibility that spiral CT scans could be an effective tool in detecting this disease," said Edward Gelmann, M.D.
Evidence from early studies of spiral CT scans, which create a 3-D model of the lungs, suggests that the scans are able to find small lung cancers that might go undetected with conventional X-rays. The only way to determine whether this early detection saves lives is to conduct a large-scale scientific study, involving tens of thousands of participants over a period of five or more years, in which people receiving the spiral CT scans are tracked alongside a control group that gets X-rays. The study now in recruitment will help researchers decide whether such a large study is feasible.
The cost of spiral CT scans, usually between $300 and $1,000, is generally not covered by insurance. About half of the hospitals in the United States own spiral CT machines, and some have begun aggressively advertising the scans for the early detection of lung cancer, despite the lack of evidence that the scans reduce a person’s likelihood of dying from lung cancer. A recent report published in the Journal of the National Cancer Institute suggests that because scarring from smoking and other non-cancerous changes inside the lungs tend to mimic tumors on spiral CT scans, the use of CT scans may lead physicians to recommend what turn out to be unnecesssary biopsies or surgery—which could in turn cause complications such as chronic pain or nerve damage.
Lombardi will recruit during September and October; participants will be randomly assigned to receive either the spiral CT scan or a chest X-ray. Researchers will compare the lung-cancer detection rate for each screening method. In addition, they will track the number of study participants who declined to take part in the study because they wanted to ensure they would be assigned to the group receiving the spiral CT scans. They will also examine how much and what kind of medical follow-up is needed for positive or uncertain results, and how frequently participants receive spiral CT scans outside of the study. Participants must be between the ages of 55 and 74, and have a history of long-term or heavy smoking. Former smokers must have quit within the last 10 years. People who have been previously diagnosed with lung cancer are ineligible.
Board certified radiologists will review each CT scan and X-ray; results will be mailed to participants within three weeks of the screening. The screening center will recommend standard follow-up care for patients with positive chest X-rays. Because no standard of care exists for followup of spiral CT scans, participants with suspicious scans will be referred to their primary care physician and advised to consult with a lung cancer specialist.
Lung cancer is expected to claim 156,900 lives this year, and about 164,000 new cases will be diagnosed this year as well—usually only after symptoms appear. No screening technology has yet been proven effective in reducing the number of deaths from lung cancer.
For more information about the Lung Screening Study, or for information about quitting smoking or lung cancer, call the Lombardi CancerLine at (202) 784-4000.
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