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At the heart of general practice since 1960

New research spotlights cancer screening, diagnosis and referral

Dramatic benefits for lung cancer screening

Screening

Screening for lung cancer using spiral CT has spectacular benefits in cutting mortality from the disease, a major international trial reports.

The study of 31,567 high-risk patients achieved a 10-year survival rate of 80 per cent – more than 10 times higher than usual.

Lung cancer specialists demanded new research to test the cost-effectiveness of spiral CT in the UK, following publication of the research in last week's New England Journal of Medicine.

The International Early Lung Cancer Action Program found annual spiral CT screening flipped survival figures on their head, turning 95 per cent death rates into survival rates of up to 90 per cent. The researchers screened asymptomatic people with a history of smoking, occupational exposure to carcinogens or exposure to second-hand smoke.

In 412 patients identified with stage I lung cancer, 10-year survival was 88 per cent, rising to 92 per cent in 302 patients with stage I cancer treated by surgical resection within a month of diagnosis. And 10-year survival for all participants, regardless of tumour stage or treatment, was 80 per cent.

Study leader Professor Claudia Henschke, professor of radiology at Cornell University, US, said the study offered 'compelling evidence' for annual spiral CT screening in at-risk patients.

She said the research 'offers hope for millions of people at risk and could dramatically reverse lung cancer death rates'.

Dr Mick Peake, NHS national clinical lead for lung cancer and chair of the UK lung cancer coalition, said it was 'scandalous' previous research showing benefits for lung cancer screening had been ignored.

Dr Peake, a consultant in respiratory medicine at Glenfields Hospital in Leicester, called for UK research to test spiral CT 'in the context in which it would be used'.

But Dr Anthony Brzezicki, a GP in south Croydon and cancer lead for Central Croydon PCT, was highly sceptical: 'Chest X-ray screening has been tried in the UK and scrapped, because it creates more work and false positives than we can cope with.

'I don't think lung cancer screening would work in general practice, in the US or UK.'

lanekwe@cmpmedica.com

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