Earlier this year, I wrote a blog entry about the news surrounding an important study involving CT and lung cancer screening. Now, the same study is making big headlines again as stronger (final) findings have been released. According to CNN, the study found that “low-dose CT screening reduces the number of lung cancer deaths in high risk smokers by 20 percent.”
Here’s another interesting fact coming out of the latest data: In high-risk populations, lung cancer CT screening can save a life for every 300 people screened. That’s more potential lives saved than mammography, colonography and prostate cancer screening COMBINED!
The only hitch: lung cancer CT screening is not covered by most insurance. However, many hospitals and imaging centers are offering this service at attractive rates for those who are willing to pay themselves.
In the last few months I’ve read several stories concerning research about CT screenings for lung cancer.
In mid-November, there was a story making the rounds among the major news outlets about a study that found that CT lung scans can reduce the risk of lung cancer death among former and current heavy smokers. During the excitement of this study, a New York Times piece was published that expressed concern that the study’s findings could easily be taken out of context – and perhaps incite unnecessary fear, as well as drive demand for unnecessary scans.
I’d like to point out the importance of this study: it showed a 20 percent reduction in mortality in patients at very high-risk who were screened with low dose CT compared to patients who were not. Several things to keep in mind about this study – first, it was a study of patients with 30 or more pack-years of smoking history. Second, the technique was a quick and a low dose CT. And third, the costs of false positive findings and their workup have not yet been analyzed.
Now, another study is gaining traction that provides even more support for the findings of the November study. While this data suggests that screening can lower lung cancer mortality substantially in high-risk individuals, what we don’t yet know is the cost of a QUALY – a quality adjusted life-year. Calculating that cost involves knowing how much society had to expend paying for CT exams and the costs of false-positive results in order to capture a saved life-year in an at-risk person. Generally, if you can save a QUALY for $50,000 or less, it’s worth doing. If more, it’s a debate.
Just some things I’ve been thinking about as more and more news agencies report on these findings. I’m interested in learning what you think – what’s your opinion on these studies? Was the New York Times piece correct in its cautionary tone? Or could these findings, in fact, be as revolutionary as some reporters (and researchers) want us to believe?