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Posted by M G F on June 1, 2012, 6:34 pm
Please forgive some background information that might not be necessary.
About ten or twelve years ago medical researchers started getting hyper-interested in the possibility of using CT and PET scanning for early detection of lung cancer. I think there was interest before then, but that was when it started showing up a lot in the medical literature. Initially, the question was whether or not the scans would even reveal early-stage lung cancer or abnormalities that could reliably be identified as pre-cancerous. To paraphrase one radiologist I know who specializes in thoracic imaging, lungs in particular: “I could take all sorts of pictures of your lungs and see all sorts of stuff, but identifying it is a crap shoot. For all we know, that spot could be a pre-cancerous tumor or a souvenir from a two week trip to city with really bad air pollution when you were ten.”
Assorted small studies were done all over the United States and didn’t amount to much. While most of them did confirm that lung cancer could be diagnosed, the poor reliability still meant that it was, essentially, a crap shoot. The studies got a tiny amount of press and the issue faded away with the conclusion that the risk of CT scans leading to unnecessary additional tests was high enough to not warrant recommending them as a standard procedure.
[Slightly Off-Topic Side Note: At the time, and subsequent studies have shown that CT and PET scans are very good at diagnosing an assortment of other things including emphysema and histiocytosis, but those uses have not been pursued nearly as energetically. Although Marcus has depicted some of those uses in some of his fiction, they are rarely used that way in real life. CT and (particularly) PET scans done by skilled technicians, who can fiddle with the resolution and get creative with assorted injected and inhaled radioactive dyes, can produce some very revealing and WAY cool images. You can’t find much of the cool stuff online but there is enough that it is worth looking a little. I hope to use some of them in a couple of future art projects I have fermenting in the back of my mind.]
Research continued, however, as technology improved and we gained a better understanding of how to use it; but the issue of whether or not CT scans should be used as a routine screening method to detect lung cancer in high risk individuals faded away for the most part. Well, the issue has emerged again as a result of a major multi-year study called the National Lung Screening Trial (NLST) . It focused on people who had smoked for 30 or more pack years and were between age 55 and 75. Only part of the results of the study have been released, but they reportedly indicate a roughly 20% reduction in lung cancer deaths in the study group receiving CT scans. Even though there has not been a rush of medical organizations to recommend regular CT scan screening for lung cancer detection (For one thing, it is expensive as hell and not covered by most insurance policies. For another thing, a 20% reduction in deaths isn’t really as impressive as it appears at first blush.), but a few have jumped on the bandwagon and there has been some mild buzz about it in the popular press. I predict that there will be more. For more information about the NLST see the Mayoclinic.com web site.
I’d like to know folks visceral and intellectual reactions to the issue.
Responses