Risk Model Emerges for CT Lung Cancer Screening!

A new risk model for lung cancer was recently highlighted in the August 21 issue of Annals of Internal Medicine. According to the report, the Liverpool Lung Project (LLP) risk model was developed to determine, based on specific and sophisticated assessments, which individuals would benefit most from CT lung screening.

The LLP risk model has a strong ability to predict lung cancer, and, according to principal investigators, does so better than smoking duration or family history. In fact, this data has been confirmed by researchers from the University of Liverpool, as well as several U.K. centers, the U.S. National Cancer Institute, and the Harvard School of Public Health.

Unlike some other major diseases, like breast cancer and heart disease, lung cancer, thus far, has lacked adequate identification tools to determine which patients should be targeted to maximize screening benefits, and minimize its potential harms. Identification of those with the highest risk for lung cancer, a disease which now kills upwards of 1 million annually, will make the best use of the benefit-harm ratio.

Though other risk models have been created, none have been able to successfully apply to all of the world’s population. The LLP could overcome these challenges, though, as it accounts for important risk factors that others skip, including history of pneumonia, non-lung cancer, and asbestos exposure, among family history and smoking history.

The model certainly appears a good way to improve patient selection. As always, the key inscreening exams is to do no harm. Even for those patients deemed appropriate for screening by the LLP, the best approach is with ultra-low dose CT— such as done with model based iterative reconstruction.

To learn more about the LLP, please click here!

Emphysema Found on CT Scans Points to Increased Lung Cancer Risk

That there are strong associations between smoking and emphysema and smoking and lung cancer is well established. Therefore, it’s of little surprise that a report from Lung Cancer finds emphysema that is visible to radiologists from CT scans is correlated with an increased risk of lung cancer.

However, these results were only discovered when the emphysema was read by radiologists— and not by computer interpretation. Researchers point out that radiologists and automated computer software likely detect different types of emphysema- with only doctors appearing to detect the type of emphysema associated with lung cancer. This clearly highlights the “intuition” factor in scan interpretation by experienced radiologists—a factor not yet evident in intelligent computers!

Patients that are found to have emphysema detected by CT scans are already at an increased risk of developing lung cancer and should quit smoking as soon as possible. It is interesting to remember that before cigarette smoking became widespread, both lung cancer and emphysema were exceedingly rare diseases. Those high risk patients should explore the benefits of lung cancer screening and lung cancer screening programs.

For more information on the benefits of lung cancer screening, please see here.