Low-dose CT screening improves the survival rate of lung cancer patients

Low-dose CT screening improves the survival rate of lung cancer patients

According to a large-scale international study conducted by Mount Sinai researchers at the annual meeting of the Radiological Society of North America.

The results show that patients diagnosed with early-stage lung cancer using CT screening have a 20-year survival rate of 80 percent. The average five-year survival rate for all lung cancer patients is 18.6 percent because only 16 percent of lung cancers are diagnosed at an early stage. More than half of people with lung cancer die within a year of diagnosis, making it the leading cause of cancer deaths. By the time symptoms appear, it is often too late.

The findings are the latest to show the importance of routine and early screening in detecting cancers when they are small enough to be cured by surgical removal. Unfortunately, fewer than 6 percent of people eligible for screening get it.

Although screening does not prevent cancer from occurring, it is an important tool for detecting lung cancer in its early stages, when it can be surgically removed. Ultimately, anyone interested in screening needs to know that if they are unfortunate enough to develop lung cancer, it can be cured if caught early.

Claudia Henschke, PhD, MD, lead author of the study, professor of diagnostic, molecular and interventional radiology and director of the Early Lung and Cardiac Action Program at the Icahn School of Medicine at Mount Sinai in New York

While treating advanced cancers with targeted therapy and immunotherapy has come a long way, the best way to prevent lung cancer deaths, according to the study authors, is early detection through low-dose CT screening before symptoms appear.

“Symptoms occur primarily in late-stage lung cancer,” said Dr. Henschke. “The best way to detect early-stage lung cancer is therefore to participate in an annual screening program.”

The US Preventive Services Task Force recommends annual lung cancer screening with low-dose CT in adults aged 50 to 80 years who have a 20 pack-year smoking history, which is at least one pack per day for 20 years, and who currently smoke or have quit in the last 15 years.

The study tracked the 20-year survival rate of 1,285 patients screened through the International Early Lung Cancer Action Program (I-ELCAP) who were later diagnosed with early-stage lung cancer. While the overall survival of the participants was 80 percent, the survival rate for the 139 participants with non-solid cancerous lung nodules and the 155 participants with nodules with partially solid consistency was 100 percent. Among the 991 participants with solid nodules, the survival rate was 73 percent. For participants with stage 1A cancer measuring 10 mm or less, the 20-year survival rate was 92 percent.

Dr. Henschke and colleagues have been studying the effectiveness of cancer detection using low-dose CT screening for years. Researchers' efforts to advance CT screening for early lung disease led to the development of the I-ELCAP. Launched in 1992, this multi-institutional, multinational research program has enrolled more than 87,000 participants from over 80 institutions.

In 2006, researchers identified a 10-year survival rate of 80 percent for patients whose cancer was detected through CT screening. For this study, they examined 20-year survival rates.

“What we present here is the 20-year follow-up of participants in our screening program who were diagnosed with and subsequently treated for lung cancer,” said Dr. Henschke. "The key takeaway is that even after this long period of time, they don't die from their lung cancer. And even if new lung cancers were found over time, they would be OK as long as they continued with annual screening."

Co-authors are David F. Yankelevitz, MD, director of the Lung Biopsy Service at Icahn Mount Sinai; Daniel M. Libby, MD, professor of medicine at Weill Cornell Medical Center; James Smith, MD, clinical professor of medicine at Weill Cornell Medical Center; Mark Pasmantier, MD, Weill Cornell Medical Center, and Rowena Yip, MPH, senior biostatistician at I-ELCAP at Icahn Mount Sinai.

Source:

Mount Sinai Health System

.