Page 12 - Delaware Medical Journal - March/April 2020

Early Lung Cancer Screening:
There Will Always Be Naysayers
Nicholas Petrelli, MD; Stephen Grubbs, MD; James Spellman, MD; Heather Bittner-Fagan, MD; Albert Rizzo, MD
The United States National Lung Screening Trial (NLST) publication in 2011 revealed a 20% reduction
in lung cancer mortality with low-dose computed tomographic (CT) screening.1 This is critical because lung cancer is
still the leading cause of cancer deaths worldwide. It causes more deaths than the combined total of breast, colorectal, and cervical cancers.2 This is especially critical in the state of Delaware, where lung cancer is responsible for 33% of all cancer deaths. The U.S. National Lung Screening Trial
required three annual CT screenings and compared this to screening with the use
of chest radiography. There were 53,454 participants at high risk for lung cancer after a median follow-up of 6.5 years. This mortality at a median follow-up of 5.5 and 6.0 years was as much as 19% lower with CT screening as with chest radiography.1,3 An independent review and modeling study4,5 by the U.S. Preventive Services Task Force resulted in the recommendation to annually screen persons aged 55 to
80 with a smoking history of 30 or more pack years, who currently smoke or quit smoking within the past 15 years. Until recently, no other trial of lung cancer lung cancer mortality.
This changed with a 2020 publication in the New England Journal of Medicine: the Dutch-Belgium lung-cancer screening trial by de Koning and Associates.6 In the Dutch-Belgium lung-cancer screening trial, 15,792 participants were randomly
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Del Med J | March/April 2020 | Vol. 92 | No. 2