Little value seen in CT scans for lung cancer screening

Computed tomography (CT) scans widely marketed to consumers may not be valuable for mass screening of lung cancer, a Johns Hopkins study has found.

Results of the study, published in the Jan. 15 issue of The Journal of the American Medical Association, show that the number of lives saved by annual whole body CT screening may be outweighed by its costs and the harm of unnecessary testing for lung nodules identified that turn out to be benign. Screening was increasingly less cost-effective for those who quit smoking at the time of the first screening and for former smokers.

"Direct-to-consumer marketing and media coverage of CT trials has encouraged demand for lung cancer screening despite a lack of evidence for its efficacy," says lead author Parthiv J. Mahadevia, M.D., M.P.H., a research scientist at MEDTAP International in Bethesda, Md., who was a Robert Wood Johnson Clinical Scholar at Johns Hopkins when the study was completed. "These scans are not risk-free. There is a downside to this, including high costs and possible harm to individuals who may unnecessarily get invasive procedures if the scan detects a benign lung nodule."

An estimated 50 million men and women in the United States have ever smoked between the ages of 45 and 75, the authors note. If just half of this group received periodic annual screening, the program costs would be approximately $115 billion.

The National Cancer Institute has begun an eight-year trial comparing CT scans to chest X-rays in the diagnosis of lung cancer. But until there's solid data, consumers may want to hold off on the screenings, says senior author Neil R. Powe, M.D., M.P.H., director of Johns Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research. Smoking cessation is the only proven, cost-effective method to reduce lung cancer risk, he says.

"We're not down on the technology, just its injudicious use," says Powe, also a professor of medicine and epidemiolog

Contact: Karen Blum
Johns Hopkins Medical Institutions

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