You probably get annual mammograms to screen for breast cancer if you're female and over 40. But what if you're a current or former smoker, and have a family history of lung cancer? Do you get annual screenings for lung cancer? Probably not.
Lung cancer is much more difficult to diagnose than breast cancer. Conventional X-rays produce an unacceptable number of false positives for lung cancer. Sputum cytology is another screening test that works more like a pap smear: lab technicians examine cells from the lungs to see if they appear cancerous. Unfortunately, it's not very effective either. Clinical trials in the 1970's failed to show any reduction in lung cancer mortality from these screening methods.
Low dose spiral computed tomography (CT) scans offer better diagnostic images. The National Lung Screening Trial recently announced results that CT scans can reduce lung cancer deaths by 20 percent. The National Cancer Institute offers this statement from Harold Varmus, M.D., NCI Director:
“Lung cancer is the leading cause of cancer mortality in the U.S. and throughout the world, so a validated approach that can reduce lung cancer mortality by even 20 percent has the potential to spare very significant numbers of people from the ravages of this disease. But these findings should in no way distract us from continued efforts to curtail the use of tobacco, which will remain the major causative factor for lung cancer and several other diseases.”
I expect CT screenings will be most valuable for former smokers. The risk of lung cancer remains elevated for a decade after smoking cessation. Based on what I've seen from my smoking friends, I really don't think anyone who is still smoking will agree to the test. Of course, I could be wrong. Maybe the availability of the test will motivate some smokers to quit.
In other news, the National Lung Cancer Partnership reports that Americans are still in the dark about lung cancer. In a recent survey, 83 percent of women did not know that lung cancer kills more women than breast cancer, and 75 percent of men did not know that lung cancer kills more men than prostate cancer.