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+++++++++++ + + +++++++++++ Q&A +++ +++ Lung Cancer Screening Centers for Disease Control. This is true for both men and women. Recently a large-scale National M Cancer Institute (NCI) study, called the National Lung Screening Trial (NLST), found that low-dose helical computed tomography (CT) detected lung cancer at an earlier more treat- able stage than standard chest x-rays, thus reducing the risk of dying from lung cancer by 20 percent in middle age and elderly smokers. MD News asked Philip Linden, MD, chief of Thoracic and Esophageal Surgery at University Hospitals Case Medical Center and associate profes- sor of Surgery at Case Western Reserve University School of Medicine, about this study and the use of CT for lung cancer screening. Q Tell us about the NCI study and its results. A: Preliminary results of NLST were released last fall; full results, in the spring. The study looked at CT scan vs. chest x-ray and their ability to save lives through early detection of lung cancer. ORE PEOPLE IN the United States die from lung can- cer than any other type of cancer, according to the Patients who were heavy smokers or ex-heavy smokers were enrolled in the study. Half were randomized to receive CT scans once a year for three years. The other half received chest x-rays. All were followed for five years. The results showed that heavy smokers who received CT scans were 20% less likely to die from lung cancer, because cancer was detected earlier with a CT scan than with a chest x-ray. Q Was this the impetus for University Hospitals lung cancer screening program? A: Yes. We're the first in the area to offer low-dose, spiral multi-slice CT as a lung cancer screening modality for smokers. It's very similar in concept to annual mammograms for patients at risk for breast cancer. Of course, mam- mograms are advocated for all women over age 40, but CT scans for lung cancer screening should really only be used for appropriate patients who meet the criteria. The patient population we're recommending this for is the same as the NLST — individuals between the ages of 55 and 74 who have smoked at least a pack a day for 30 years or more (or the equivalent, i.e, two packs per day for 15 years) and have not stopped smoking within the last 15 years. A physician referral is also required to obtain the screening. Q From a patient's perspective, how long does the screening take? And what percentage of the patients who are screened are found to have lung cancer? A: The new scanner we're using at UH Seidman Cancer Center is extremely fast — it can image the chest in less than fi ve seconds and with one-fi fth the radiation dose of regular CT scanners. It will only take about 15 minutes to come in, have the scan and be fi nished. About one-quarter of screened patients will have some abnormality. The vast majority of these abnormalities won't be cancer. It's important that the screening be done in a center with experienced clinicians, such as UH Seidman Cancer Center, so that an appropriate decision can be made as to which abnormalities need to be biopsied and which can simply be followed. In the event cancer is diagnosed, a multidisciplinary team of specialists — oncologists, surgeons, pulmonologists and radiologists — is readily available to give advice regarding care and treatment. The goal is to detect lung cancer earlier when it is highly curable. CT scans for lung cancer screening are currently not covered by insurance but are offered at the UH Seidman Cancer Center at a reduced rate. For more information or to refer a patient, call 216-844-2273. s