For our 9th video in the GRACE Spanish Lung Cancer Library, Brian Hunis, MD joined GRACE to discuss the pros and cons of lung cancer screening.
Drs. Ben Solomon, Leora Horn, & Jack West review impressive data demonstrating a striking survival improvement from successful efforts at smoking cessation among smokers undergoing lung cancer CT screening.
One of the challenges of the increased frequency of chest CT scans being done for screening of people at higher risk of lung cancer, or done more commonly for chest symptoms, is that lung nodules are very commonly found, but most the time they aren't cancer. Most studies show that >90% of lung nodules are benign, but the majority lead to additional work-up, and in nearly 100% of cases, they cause anxiety for the patient. What if a blood test could help clarify the probability that someone doesn't have a lung cancer?
The concept of "over-treatment" of lung cancer may sound heretical to some here, as it is unquestionably a fearsome cancer. Nevertheless, it's important to recognize that cancers can range from quite indolent to virulently aggressive and that some forms may be so minimally threatening that treatment may be worse than the disease.
The most pivotal study supporting the value of screening for lung cancer is the National Lung cancer Screening Trial (NLST), which revealed a 20% improvement in overall survival in patients with sufficiently high risk of lung cancer and who underwent an annual chest CT scans vs. chest x-ray over a three year period.