U hopes to catch lung cancer sooner with X-ray study

Kelly Custer

The University Cancer Center received an $8.5 million grant from the National Cancer Institute in an effort to determine whether a three-dimensional screening device leads to fewer lung cancer deaths than a traditional chest X-ray.

The Cancer Center will join the National Lung Screening Trial, a nationwide study that will weigh the effectiveness of the costly Spiral CT screening device.

The Spiral CT, developed in the early 1990s, provides radiologists with a three-dimensional view of the lungs.

Patients lie on a table that moves through a doughnut-shaped machine, which rotates around the patient while taking a continuous picture. It’s more sensitive than a traditional chest X-ray and can detect growths or tumors as small as 3 millimeters. The traditional X-ray detects growths as small as 1-2 centimeters.

But the Spiral CT is controversial. Cancer researchers are concerned that finding such small growths – which may be harmless – could invite potentially risky procedures.

Needle biopsies remove cells through the chest wall, and a thoracotomy, a very invasive procedure, removes substantial amounts of lung tissue.

“Going in and taking pieces of the lung is not pleasant and not without risk itself,” said Tim Church, principal investigator of the Minnesota Clinical Center for the NLST. “The question needs to be answered: ‘Does it do more good than harm?’ “

The University will enroll 50,000 participants in the study over the next two years. Participants will undergo three annual screens – either Spiral CT or chest X-ray – and will have follow-up appointments for the next three years.

“Lung cancer kills more people in the United States than any other cancer,” Church said. “It’s a very deadly cancer; if you get it you’re very likely to die from it.”

Approximately 160,000 people nationwide were diagnosed with lung cancer last year and 150,000 died from it.

Doctors and scientists involved in the screening research hope that early detection can help save lives.

“If we find these cancers very, very early, we may be able to cure it,” Church said. “It’s very hard to cure people once they get lung cancer. If there’s any chance to cure them, it’s to find it early when it hasn’t spread anywhere.”

Potential participants in the study must be between 55 and 74 years old, and must be current or former smokers who have smoked the equivalent of a pack a day for 30 years.

The study will pay for the screens, which cost between $50 and $200 for chest X-rays and $350 to $1,200 for the Spiral CT.

“This is a huge study because so far nothing has been proven beneficial in screening for lung cancer,” said Marty Oken, medical oncologist and research director for the study. “There is a possibility that it could lower mortality in the country 20 percent – 32,000 people a year in the United States would be meaningful.

“If there’s a large difference (between screening methods), we’re sure to find it,” Oken said.