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Wow! Lung cancer accounts for 27% of all cancer deaths in the United States. 7% of Americans will be diagnosed and 6% will die from it.   Among heavy smokers, 33% of them will die from lung cancer.   In the 1960s and 70s, annual screening with chest x –ray was recommended in smokers. At the time this seemed to improve survival, but more recent studies have shown that this does not reduce lung cancer deaths.

More recently we have thought that low-dose CT scan of the lungs showed promise for the early detection of lung cancer. After rigorous randomized controlled trial, an annual low-dose CT screening is recommended to those with risk. persons 55 to 80 years of age with at least a 30-pack-year history (for example, one pack-per-day for 30 years) who are otherwise healthy smokers or who have quit smoking within the previous 15 years.

The results of this low-dose CT of the lung has showed that those in the lowest lung cancer risk were unlikely to have any benefit. Studies showed more than 96% of all positive results in the lowest lung cancer risk group were false positives (the test showed cancer when indeed there was none). Another drawback is that we are unsure of the cumulative effect of annual screenings with radiation exposure.

Perhaps the most important issue with low-dose Ct lung screening is that the technology is available, but that this is a costly test in response to what is a behavioral and lifestyle problem. Researchers note that smoking is responsible for 85% of lung cancers. Our job as physicians to offer smoking cessation programs is far more effective in preventing lung cancer deaths than low-dose CT lung screening. The CT screening cannot prevent most lung cancer deaths compared to smoking cessation.

So, smoking cessation programs are the key. Low-dose CT lung screening is also an option.