CT scans for lung cancer trigger debate

Washington Post : A recent federal study found that screening heavy smokers and former smokers who are 55–74 years old reduced by 20% the chances of their dying of lung cancer. As a result, CT scans are being used more frequently to screen people for lung cancer, prompting significant disagreement about how widely the testing should be done. Lung cancer, the leading cause of cancer death in the US, is still difficult to treat, partly because it’s often diagnosed late. The three-dimensional images created by CT scans are more detailed than 2D x rays and, therefore, more likely to reveal small tumors in the lungs, earlier in the course of the disease. The potential downside is that greater detail can produce more false positives, and follow-up procedures, such as biopsy and surgery, have significant risks of their own; of the 16 patients in the study who died of follow-up procedures, 6 did not have cancer. Some testing centers are offering CT scans to patients outside the age and risk profile of the test participants, which may increase the false-positive rate as well as the number of unnecessary and risky follow-up procedures performed.