Full results of a big study that showed some smokers’ lives could be saved by screening with lung scans now reveal more clearly what the risks are: There’s a good chance of a false alarm.
Of those who got the recommended annual scans for three years, four out of 10 had a suspicious finding on at least one scan and were advised to have a follow-up test or biopsy. And more than 95 percent of them turned out to have nothing wrong.
The results out Wednesday give the first detailed look at the benefits and risks of screening longtime current or former smokers with special X-rays called CT scans.
The government stopped the study last fall after seeing the scans were saving lives.
Most insurers don’t cover the scans because no major groups currently recommend them.
But guidance on smoker screening is likely to change with the study’s results, which may help the nation’s 94 million current and former smokers decide whether to be screened.
“The question has changed to how are we going to do this,” not whether we should, said Dr. Harold “Hal” Sox, a Dartmouth professor who used to head the government task force that shapes policy on screening tests. He wrote an editorial with the results, published online Wednesday by the New England Journal of Medicine.
The study tested CT scans versus ordinary chest X-rays in 53,454 people over 55 with more than 30 pack-years of smoking: a pack a day for 30 years or two packs a day for 15 years.
Numbers to know
• Three: The number of scans, one each year, that showed benefit in this study. No one knows whether a single scan or testing less often would help.
• 20 percent: The reduction in the risk of dying from lung cancer among those given CT scans (356 deaths versus 443 in the X-ray group).
• 7 percent: The reduction in the risk of dying from any cause during the study (1,877 deaths in the CT group versus 2,000 in X-ray group).
• About 320: The number of people who would have to be scanned for three years to prevent a single death from lung cancer. That’s impressive when compared with the 1,339 women in their 50s who would need to have mammograms for several years to avoid one breast cancer death.
However, mammograms are cheaper and involve less radiation, so the risks and benefits aren’t quite the same.
• $300 to $1,200: The average range of charges for a CT scan.
The Associated Press
