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Earlier screening, diagnosis decrease lung cancer deaths: study

by John R. Fischer, Senior Reporter | December 29, 2021
CT X-Ray
Earlier CT screening has helped reduce lung cancer mortality by 4% annually
Earlier screening and diagnosis have decreased lung cancer deaths by about 4% each year since 2006, along with late-stage diagnoses. That’s what researchers at Mount Sinai are saying in a new study that evaluated the impact of increasing earlier screenings.

Between 2006 and 2016, early-stage diagnoses rose from 26.5% to 31.2%, while late-stage ones dropped from 70.8% to 66.1%. Additionally, the median length of survival in early-stage patients was 57 months, and seven months in late-stage ones. The report is the first time a large population-based study has shown that early detection leads to a decrease in lung cancer mortality by detecting cancer at earlier stages.

With earlier detection from increased screening via CT, clinicians can set to work removing any precancerous and early-stage nodules found with surgery, which is often curative. They can also do the same for follow-up potential scanners found on scans initiated to study other organs or diseases.
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"We expect to shift more towards early stages as lung cancer screening gets a hold in the next few years. Similarly, prognosis may improve considerably because of the more favorable outcomes observed in early stages, and the more efficacious therapies used in later stages," Dr. Emanuela Taioli, director of the Institute for Translational Epidemiology and associate director for population science at The Tisch Cancer Institute at Mount Sinai, told HCB News.

She adds that changes in smoking habits, the introduction of e-cigarettes and environmental exposure to PAH and other carcinogens will also affect the prevalence of lung cancer and that more changes will be seen in sex, histology distribution and stage as well.

The authors evaluated 312,382 patients with non-small cell lung cancer, which is the most common form of lung cancer diagnosed. The study was a retrospective analysis and used cases from the Surveillance, Epidemiology, and End Results (SEER) Program, an authoritative source for cancer statistics.

Despite early screenings increasing, studies on their impact on non-small cell lung cancer mortality is limited compared to those on the association of smoking cessation, earlier interventions and targeted therapies.

In 2013, the U.S. Preventive Services Task Force recommended at-risk individuals be screened annually for lung cancer with CT, and earlier this year it issued final guidelines recommending that annual screenings start at 50 instead of 55 for current and former smokers. The guidelines pertain to those who still smoke or have quit in the last 15 years and refers to those 80 or under. They also redefine the definition of a heavy smoker as someone with a 30 pack-year history (one pack a day for 30 years) to a 20 pack-year history.

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