Published on September 19, 2014

Are the politics of smoking polluting public policy and the fight for low dose CT lung cancer screening? 

By Teri Yates, Accountable Radiology

The outlook for people living with lung cancer has always been exceptionally grim.  More than half of all patients do not even survive a year after diagnosis, primarily because nearly all lung cancers are detected after the disease has spread to other parts of the body. In its early stages, lung cancer is silent and symptomless, but like so many other cancers when caught in the early stages, it can be treated and in many circumstances it can be cured. The question is, how do we find lung cancer early?

In 1992, physicians at Cornell University Medical Center began looking for the answer to that question, forming the Early Lung Cancer Action Program (ELCAP) to determine if screening with low-dose CT could detect cancer at an earlier stage than chest radiography. ELCAP eventually became an international effort (I-ELCAP), and its promising findings prompted the National Lung Screening Trial (NLST), a randomized clinical trial that examined whether low-dose CT screening could prevent lung cancer deaths in high-risk patients.

Twenty-two years later, the collective work undertaken by these researchers has proven that annual screening with CT is effective at detecting early stage lung cancer, and more importantly that lung cancer screening can prevent 20% of lung cancer deaths. Armed with the necessary evidence demonstrating the effectiveness of screening, researchers and lung cancer advocacy groups have been working diligently to secure insurance coverage for this new and important preventive health service.