What Is Pulmonary Arterial Hypertension (PAH)?
Use Of CT Scans To Detect Lung Cancer Questioned
A new study by the researchers at the Johns Hopkins University School of Medicine in Baltimore cautioned that Computed Tomography(CT) scans may not be valuable for mass screening for lung cancer. They claimed that the harm of unnecessary testing for lung nodules detected by the CT scan that turn out to be benign, and the costs of the scan far outweigh the number of lives saved by annual full-body CT screening.Following this, the National Cancer Institute has begun an eight-year trial comparing CT scans with chest x-rays in the diagnosis of lung cancer. The study's senior author Neil R. Powe, MD, MPH, director of Johns Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research concluded that consumers may want to hold off the screenings until solid data is available. He also added that smoking cessation is the only proven, cost-effective method to reduce lung cancer risk.
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What Does Lung Cancer Look Like?
If you have lung cancer, imaging tests like a chest X-ray will typically show a visible mass or nodule in your lungs. It will look like a white spot against the backdrop of a black lung.
An estimated 238,340 in the United States will be diagnosed with lung cancer by the end of 2023. Lung cancer is the second most common form of cancer in men and women in the United States.
Though a lung cancer diagnosis is serious, new and increasingly effective treatments are being researched every day. Early diagnosis and treatment may lead to a positive outlook.
Though lung cancer is common and can feel scary, the number of new lung cancer cases is decreasing, most likely due to positive lifestyle changes in the population and new treatments.
Here are some pictures to illustrate what lung cancer looks like.
Non-small cell lung cancer (NSCLC)Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, making up about 80-85% of all cases. There are three main subtypes of NSCLC: Adenocarcinoma, large-cell carcinoma, and squamous-cell carcinoma.
There are also two less common types of NSCLC:
Only about 10-15% of all lung cancers are SCLC. This type can spread quickly and is often more challenging to diagnose early.
SCLC often responds well to chemotherapy and radiation, though it may often recur after treatment.
Lung cancer tumorsOther types of tumors can also occur in the lungs. Called carcinoids, these tumors grow slower than other types of lung cancer.
Carcinoids typically form in the lungs' airways — the bronchi (large airways) or bronchioles (narrow airways). A person may have different symptoms depending on where the tumor is growing, and the treatment may be different depending on where, exactly, the tumor is.
Carcinoids don't usually spread to other areas of the body. They aren't caused by smoking.
Several tests will allow your doctor to make a lung cancer diagnosis:
Chest X-rayIf you have any symptoms of lung cancer, your doctor may order a chest X-ray. A chest X-ray of someone with lung cancer may show a visible mass or nodule.
This mass will look like a white spot on your lungs, while the lung itself will appear black. However, an X-ray may not be able to detect small or early-stage cancers.
CT scanA computed tomography (CT) scan is often ordered if there is something abnormal on the chest X-ray. A CT scan takes a cross-sectional and a more detailed image of the lung. It can give more information about abnormalities, nodules, or lesions — small, abnormal lung areas seen on X-ray.
A CT scan can detect smaller lesions not visible on a chest X-ray. Cancerous lesions can sometimes be distinguished from benign lesions on chest CT scans.
Your doctor cannot diagnose cancer with only an image from a CT scan or an X-ray. If they are concerned about the results of image tests, they will order a tissue biopsy.
Sputum cytologyIf you can produce phlegm when you cough, microscopic cancer cells may be seen in this form of screening.
BiopsyIn a biopsy, your physician will take a tissue sample from your lungs for examination.
This sample may be removed via a tube placed down your throat (bronchoscopy), an incision at the base of the neck (mediastinoscopy), or by making an incision in the chest wall and using a needle to collect the sample.
A pathologist can then analyze this sample to determine if you have cancer. More testing may be needed to determine if the cancer has spread to other areas.
What is stage 1 lung cancer like?This depends, first of all, on the type of lung cancer you have. In the case of NSCLC, stage 1 is when the cancer has not yet spread past the tumor itself to the lymph nodes or anywhere else.
What are the three warning signs of lung cancer?Usually, you wouldn't develop symptoms of lung cancer until your disease is advanced. If you're experiencing a cough, shortness of breath, hoarseness, or any other signs that might be associated with lung cancer, and these symptoms do not improve with treatments for things like a viral illness or pneumonia, ask your doctor for a screening.
Can you see lung cancer on the skin?In rare cases, lung cancer can affect your skin. If you notice any yellowing of your skin (jaundice) or unusual skin lesions, speak with your doctor as soon as possible.
Lung cancer is one of the most common types of cancer and may require quick and aggressive treatment. Some major milestones have been reached in clinical research to find more effective methods of treating it.
If you're worried about the risk of lung cancer, speak with your doctor about screening and prevention. They can help you determine what steps to take to treat or prevent lung cancer and any related conditions.
Lung Nodule Program Provides Benefits To Patients Ineligible For Lung Cancer Screening
Adopting a lung nodule program (LNP) may increase the detection of early lung cancer for patients who are not eligible for lung cancer screening under existing age eligibility criteria, according to a study published in the Journal of Thoracic Oncology.
LNPs are established to follow up on lung nodules that are frequently identified during routine imaging for reasons other than suspected lung cancer or lung cancer screening.
The research was conducted by a team led by Dr. Raymond U. Osarogiagbon, MBBS, FACP, chief scientist for Baptist Memorial Health Care and director of the multidisciplinary thoracic oncology program and the thoracic oncology research group for Baptist Cancer Center, Memphis, Tennessee, U.S.
The prospective observational study compared the two-year cumulative lung cancer diagnosis risk, lung cancer characteristics, and overall survival (OS) among participants undergoing low-dose CT (LDCT) screening aged 50–80 years, and LNP participants aged 35 to 50 years and over 80 years of age.
The United States Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Low-dose computed tomographic (LDCT) screening for lung cancer has been shown to reduce mortality by up to 20%. However, even after lowering the age of eligibility from 55 to 50 years, most persons diagnosed with lung cancer in the US are ineligible for lung cancer screening. LNPs, which typically use Fleischner Society lung nodule management guidelines, expand access to early lung cancer detection to a more diverse population.
Persons aged 50 to 80 years enrolled in a LNP were at greater risk of lung cancer diagnosis within two years compared to an LDCT cohort. The demographic, socio-economic characteristics, and risk factor profile of patients diagnosed with lung cancer through the LNP differed strikingly from that of the screened cohort.
The lung cancer risk in persons too young or too old for screening, but who have an incidentally detected lung lesion, had not previously been rigorously estimated. According to Dr. Osarogiagbon, the study compared the cumulative lung cancer diagnosis risk, lesion characteristics, lung cancer characteristics, treatment and outcomes of screening age-ineligible persons in a LNP to an LDCT screening cohort.
The study period spanning from 2015 to 2022 revealed that lung cancer was diagnosed in 329 (3.43%) LDCT, 39 (1.07%) young, and 172 (6.87%) elderly LNP patients. Strikingly, the two-year cumulative incidence rates were 3.0% (95% CI: 2.6%–3.4%) for LDCT, 0.79% (CI: 0.54%–1.1%) for young LNP, and 6.5% (CI: 5.5%–7.6%) for elderly LNP.
Despite age differences, the lung cancer diagnosis risk was found to be similar between young LNP and Lung-RADS 1 (aHR 0.88 [CI: 0.50–1.56]) and 2 (aHR 1.0 [0.58–1.72]). In contrast, elderly LNP risk exceeded that of Lung-RADS 3 (aHR 2.34 [CI: 1.50–3.65]) but was less than 4 (aHR 0.28 [CI: 0.22–0.35]).
Moreover, the study revealed significant differences in stage at the time of cancer diagnosis, with 62.92% of LDCT cases diagnosed at stage I/II compared to 33.33% for young (p=0.0003) and 48.26% for elderly (p=0.0004) LNP cohorts. Notably, 16.72%, 41.03%, and 29.65% of LDCT, young, and elderly LNP cases respectively, were diagnosed at stage IV.
The five-year OS rates were 57% (CI: 48–67), 55% (CI: 39–79), and 24% (CI: 15–40) respectively, with statistically significant differences (Log-rank p<0.0001), persisting even after excluding persons with any prior history of cancer.
"Our findings indicate that our Lung Nodule Program modestly benefitted individuals deemed too young or too old for traditional screening," said Dr. Osarogiagbon. "The observed differences in clinical characteristics and outcomes strongly suggest variations in the biological characteristics of lung cancer in these distinct patient cohorts."
More information: Journal of Thoracic Oncology (2023).
Provided by International Association for the Study of Lung Cancer
Citation: Lung nodule program provides benefits to patients ineligible for lung cancer screening (2023, December 18) retrieved 29 December 2023 from https://medicalxpress.Com/news/2023-12-lung-nodule-benefits-patients-ineligible.Html
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