<--GAT-->

Low Radiation Scans Detect Very Early Lung Cancer

by U.S. Medicine

November 6, 2013

PHILADELPHIA – Low-dose computed tomography (LDCT) can be extremely valuable for identifying tiny lung nodules which can indicate the earliest stages of lung cancer, according to a study of veterans at high risk of the disease.1

The study, presented this spring at the American Thoracic Society (ATS) 2013 International Conference in Philadelphia, noted that LDCT uses less than a quarter of the radiation of a conventional computed tomography (CT) scan.

“Lung cancer is the leading cause of cancer-related death and has a poor survival rate,” said Sue Yoon, FNP, nurse practitioner at VA Boston Healthcare West Roxbury Division. “Most of our veterans in these ages have a heavy smoking history, and early screening is desirable to improve outcomes. Our study was undertaken to learn how often we would discover significant abnormalities and how to adapt our existing processes and interdisciplinary approaches to accommodate additional patients.”

The National Lung Cancer Screening Trial (NLST) found that LDCT resulted in a 20% reduction of lung cancer mortality compared with chest X-ray among heavy smokers aged 55 to 74 years.

The Boston study involved 56 patients, median age 61 to 65 years, with a smoking history of more than 30 pack years or of 20 pack years and one additional cancer risk factor, such as occupational exposure to carcinogens or personal or family history of cancer or chronic obstructive pulmonary disease (COPD).

Based on the LDCT scans, of each patient, the researchers found that 31 patients had a nodule of 4 mm or larger or another abnormal opacity, of which six were deemed suspicious for malignancy. The study also found that 34 patients had more than one nodule, with four patients  diagnosed with biopsy-proven lung cancer.

 “Our preliminary rate of lung cancer diagnosis after the first round of screening was 7%, which was significantly higher than NLST group, which had a preliminary rate of 3.8 percent at its first round,” Yoon said. “In addition, detection of nodules larger than 4 mm was 55% in our group compared with 27% in the NLST group.”

She suggested three reasons for the difference in nodule prevalence rates between the current study and the NLST:

  • The Boston VA study had much smaller numbers than the multicenter NLST;
  • The scanning technology used during the current trial had advanced since the earlier NLST trial was conducted;
  • The VA population was predominantly male and most patients had COPD, unlike the NLST study.

“Our previous experience with diagnosing and managing a high volume of incidentally discovered pulmonary nodules suggested that a low dose CT scan screening program, in which patients are screened annually, could be a substantial undertaking,” Yoon said. “Considerable effort goes into each step of the process: selecting patients, tracking abnormalities, further selecting patients with suspicious abnormalities for additional diagnostic and therapeutic interventions.

“Although we plan to continue and expand the LDCT screening program, this will require additional planning and, potentially, resources,” she added. “Currently we are using a gatekeeper approach, to ensure tracking of nodules and other abnormalities that are discovered during screening LDCT.”

  1. Yoon SH, Goldstein R, Jatil A, Arndt W, Haw SJ, et al. (2013, May). Abstract 29154: Low Dose CT Lung Cancer Screening Experience At A VA Medical Center. Presented at the ATS 2013 International Conference, Philadelphia, PA.

Comments are closed here.


Related Articles

Democrats Look at VA Role of Trump’s Mar-a-Lago Associates

WASHINGTON—Congress announced last month that it will be opening an investigation into alleged improper influence by three civilian consultants to President Donald Trump on administration of the VA. The three men—Ike Perlmutter, CEO of Marvel... View Article

VA Announces Proposed Standards for Access to Mission Act Outside Care

WASHINGTON—VA has released its proposed new access standards, defining new eligibility criteria for veterans seeking care by non-VA providers. The standards are part of the VA MISSION Act signed into law in June 2018, and... View Article


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

VA Announces Proposed Standards for Access to Mission Act Outside Care

WASHINGTON—Congress announced last month that it will be opening an investigation into alleged improper influence by three civilian consultants to President Donald Trump on administration of the VA. The three men—Ike Perlmutter, CEO of Marvel... View Article

Department of Veterans Affairs (VA)

VA Announces New Partnerships to Expand Telehealth Services

WASHINGTON—Congress announced last month that it will be opening an investigation into alleged improper influence by three civilian consultants to President Donald Trump on administration of the VA. The three men—Ike Perlmutter, CEO of Marvel... View Article

Department of Veterans Affairs (VA)

VA Fails to Use All Outreach Resources to Combat Veteran Suicide

Despite declaring veteran suicide as its No. 1 clinical priority, VA’s suicide prevention outreach efforts dropped off in 2017 and 2018, and a lack of clear goals and inconsistent leadership has impacted its success, according to a Government Accountability Office report.

Department of Veterans Affairs (VA)

Disabled Veteran Helps Others Like Her Get Back Into the Workforce

Ten years ago, Coniece Washington was walking through the Washington, DC, VA Medical Center when she saw a job notice tacked to a board: certified rehabilitation counselor.

Department of Veterans Affairs (VA)

Senate Blocks Agent Orange Exposure Extension to Blue Water Veterans

Blue Water Navy veterans who claim to be impacted by toxic exposure while serving off the coast of Vietnam were forced to grapple with disappointment once again as the 115th Congress ended without passing legislation addressing their VA benefits.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up