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At Preliminary Screening Test, Twice As Many Lung Cancers Identified by CT Compared to X-Ray

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lung cNational Lung Screening Trial (NLST) researchers have finalized that the 20 percent decline in lung cancer fatality with low-dose computed tomography (LDCT) opposed to chest X-ray (CXR) screenings previously accounted in the NLST first-round is attainable at skilled screening centers in the U.S.

MDs have more information to disclose to their patients about the pros and cons of LDCT lung cancer screeing as the outcome of the first of three yearly screening tests from the NLST have been published in the New England Journal of Medicine.

"For a cancer screening to work, it's important to verify that it can in fact discover cancers early.

The analysis of NLST participants' initial annual screening examination provides evidence that the number of early-stage cancers detected in the trial's CT arm were significantly greater than the number detected in the chest X-ray arm," said biostatistician and professor in the School of Public Health at the University of Minnesota, Timothy Church, while also mentioning a decrease in the mortality rate is a major sign of a triumphant cancer screening plan.

53,400 study participants were randomized and equally slotted into either the LDCT or rudimentary CXR arm to assess whether lung cancer screening saves lives.

At first glimpse, results show a 20 percent decrease in lung cancer patients (who all were at a high-risk for the disease) screened with LDCT compared to those screened with CXR.

Researches of NLST suggest the findings from the first-round of screenings to be (and will most likely remain) largely in favor of LDCT than CXR with more positive screening exams [7191 vs. 2387, respectively], more diagnostic procedures [6369 vs. 2176], more biopsies and other intrusive measures [297 vs. 121], and more lung cancers detected in the LDCT arm than in the CXR arm during the initial screening round of NLST [292 vs. 190].

Church also points-out that although there were more follow-up measures taken in the LDCT than CXR, it was still a relief that the percentage of patients who had more follow-up intrusive procedures was relatively low.

A second promising outcome was the high-rate of agreement in undertaking the LDCT examination.

"The sites complied with the low-dose CT imaging protocol specifications in 98.5 percent of all studies performed, which is outstanding considering the many thousands of scans performed," commented national principal investigator for NLST ACRIN and site co-principal investigator for the UCLA NLST team, Denise R. Aberle.

Aberle also notes the first set of results firmly indicates CT lung cancer programs with radiologists who have comparable know-how and skills, can infer those same number of cases acquired through scanners by the NLST, will surely encounter similar results.

"What we've learned from the analysis of the first-screen results provides clinicians additional facts to discuss with patients who share similar characteristics as the NLST participants (current or former heavy smokers over the age of 55)", said Church.

"The results also caution against making blanket lung cancer screening recommendations, because each person's trade-off between the risk of having an unnecessary procedure and the fear of dying of lung cancer is uniquely individual."

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