Emory
University Named Site for National Lung Screening Trial to Determine
the Best Method to Detect Lung Cancer
Emory University
has been awarded a $5 million grant to participate in a multi-institutional
investigation to study the best way to detect lung cancer in smokers,
with an end goal of saving more lives following diagnosis of the disease.
The National Lung Screening Trial (NLST) will compare two methods of
detecting lung cancer in healthy older individuals: computed tomography
(CT) and standard chest X-ray.
"Both CT scans and chest
X-rays are now used to detect lung cancer," says Kay Vydareny, M.D.,
professor of radiology, Emory University School of Medicine and principal
investigator of the NLST at Emory. "In fact, chest X-rays have been
the primary means of lung cancer diagnosis for more than 100 years.
Through past data, we now know that CT scans can pick up smaller nodules
than X-rays, some of which will be cancer. But what we don't know is
if detecting these smaller cancers early will help us decrease lung
cancer deaths. This trial will help us learn whether CT scans or chest
X-rays are better at reducing lung cancer deaths."
Funded by the National Cancer
Institute and the American College of Radiology Imaging Network (ACRIN),
this study will enroll 50,000 current or former smokers across the U.S.
over a period of eight years. ACRIN will directly fund Emory's trial,
which will enroll 1,500 participants. Those participants will be randomly
selected to receive either CT scans or X-rays to screen for lung cancer.
Screening will take place once a year for three years. Participants
will then be followed for five years after the screenings end to monitor
their health. The follow-up period will help to determine the long-term
benefits of these two detection methods.
For years, cigarette smoking
has been considered a major cause of lung cancer. Lung cancer is the
leading cause of cancer deaths among both men and women, according to
the American Cancer Society. In 2002, an estimated 154,900 people will
die from lung cancer, accounting for 28 percent of all cancer deaths.
More people die of lung cancer than of colon, breast and prostate cancers
combined.
Lung cancer is one of the
most difficult cancers to treat. When it is in the earliest, most treatable
stage, it is very hard to detect. CT scans can pick up tumors under
one centimeter in size, while chest X-rays can detect most tumors larger
than one centimeter (about 1/2 inch) in size. One would assume that
smaller tumors and more rapid detection would result in a better chance
of survival. But smaller cancers are not necessarily "early" cancers
and no scientific studies have shown that screening or early detection
of lung cancer can actually save lives. Now, the NLST should be able
to provide answers needed to determine whether CT scans or standard
chest X-rays are better at reducing a person's chances of dying from
lung cancer.
There are some risks with
using CT scans, however. The scans can sometimes detect suspicious abnormalities
which do not turn out to be lung cancer – known as false positives.
Many of these abnormalities are scars from smoking, areas of inflammation
or other noncancerous conditions that may require additional testing
to determine that they are not harmful. These tests have been known
to cause undue anxiety for patients and may sometimes lead to biopsies
or surgeries.
"Still, in some screening
cases, true cancers have been detected, many of which are in an early
stage," Dr. Vydareny says. "If there are positive findings, we will
contact participants and their primary care physicians and encourage
a consultation with a cancer specialist so that there can be appropriate
follow-up."
A diagnostic radiologist
at Emory for 11 years, Dr. Vydareny specializes in cardiopulmonary radiology
in the Division of Thoracic Imaging.
Recruitment for the NLST
will begin soon. Current or former smokers who are between the ages
of 55-74 may be eligible for this research study. Participants cannot
have had any previous history of lung cancer, but patients with emphysema,
bronchitis or other smoking-related conditions will be accepted. For
more information or to find out if you qualify for this study, please
contact Emory Health Connection at (404) 778-7777 or the National Cancer
Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
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