One of the largest clinical trials ever managed by the National Cancer Institute (NCI) ended today with news but hope the budget in jeopardy. NCI Director Harold Varmus announced at a press conference that the National Lung Screening Trial (NLST) was interrupted by a monitoring group, as there is strong evidence that lives can be saved by using high technology to X-ray imaging to screen for lung cancer. Preliminary data from the study, which involved 53,000 heavy smokers aged 55 to 74, show that deaths among people screened in computed tomography low dose (CT) were 20% lower than in people who achieved a standard radiography. The study, which began in 02, did not investigate why the CT-screened people have done better. Varmus said they are likely to have an early and effective treatment.
This is good news because no other lung cancer screening method has never reduced deaths from disease. Lung cancer is by far the leading cause of cancer death in the US, and is expected to kill about 157,000 people this year. Worldwide, lung cancer deaths are about 1.3 million per year. If NLST study is correct, it points to a way to achieve "the largest single reduction of cancer mortality in the history of the war against cancer," said James Mulshine, a cancer researcher associated with the group pro-screening advocacy, lung Cancer Alliance and vice president for research at Rush University Medical Center in Chicago, Illinois.
But the test results are worrying, too, Varmus said. They are likely to place significant new demands on health care. the main concern, said deputy director of NCI's basic science Douglas Lowy, is the enormous cost. It's not just the price of each scan which is estimated at about $ 300. What concerns Lowy is the high rate of false positives may result from mass screening. approximately 25% of the analyzes in the NLST trial identified anomalies, but the vast majority of those n were not dangerous cancers. Lowy and other experts fear that thousands of people will receive false alarms and therefore unnecessarily undergo x-rays and biopsies. Investigate each false alarm will be expensive and potentially very risky.
US health agencies will not make recommendations for individuals based on the NLST data immediately, Varmus said: The first step will be to publish a final report, peer review on study. Varmus expected in either the 2 or 3 months. Then review committees decide who should consider getting a scanner, when, and how often.
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