This is a proposal for a lung cancer screening and anti-smoking program.
Lung cancer is the leading cause of death from cancer in both men and women in the United States, killing more people than cancers of the breast, colon, cervix and prostate combined.
In the year 2005, it was estimated that there would be over 163,510 deaths in the United States alone; worldwide, more than a million die from it every year. Lung cancer has one of the worst prognoses of all cancers, with an overall cure rate of 5%. Major risk factors for lung cancer include tobacco use and certain environmental carcinogen exposures. Tobacco is associated with 87% of all cases of cancer of the lung, trachea, and bronchus. Lung cancer usually does not cause any symptoms until it has reached an advanced stage, when treatment is least likely to work. Early Stage I lung cancer discovered through early detection screening, however, has a cure rate of 70%, and for some subgroups it is even higher.International-ELCAP is an international, collaborative group consisting of experts on lung cancer and related issues from around the world. Our program will follow their protocols as closely as possible. In 1992, a group of physicians from Cornell University Medical Center (now Weill Medical College of Cornell University) joined forces with specialists from other institutions to find a common research goal. They found this goal in early lung cancer detection, and the promise offered by helical CT imaging. In 1993, ELCAP (Early Lung Cancer Action Program) was born. Numerous publications document the findings of the I-ELCAP members' work. Among these findings:
Research is ongoing, incorporating larger pools of patient data to reaffirm early findings and suggest new directions for future research and recommendations.
NEW YORK (Oct. 20, 2006) - Lung cancer can be detected at its very earliest stage in 85 percent of patients using annual low-dose CT screening, and when followed by prompt surgical removal the 10-year survival rate is 92 percent. These results, reported in the October 26 New England Journal of Medicine, would dramatically decrease the number of deaths from lung cancer - the number one cause of cancer deaths among both men and women in the U.S. The study was launched by a team of researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center in 1993 and has expanded into an international collaboration of 38 institutions in 7 countries, the International Early Lung Cancer Action Project (I-ELCAP). The I-ELCAP study is the largest, long-term study to determine the usefulness of annual screening by CT. Stage I lung cancer is the only stage at which cure by surgery is highly likely. While survival rates have been climbing for other forms of cancer, the survival rates for lung cancer have remained dismal. Approximately 95 percent of the 173,000 people diagnosed each year die from the disease - more than breast, prostate and colon cancer combined. The high death rates are a consequence of lung cancer not being detected early enough for treatment to be curative. Among the 31,567 people in the study, CT screening detected 484 people who were diagnosed with lung cancer, 412 of these were Stage I. Of the Stage I patients who chose not to be treated, all died within five years. Overall, the estimated 10-year survival rate for the 484 participants with lung cancer was 80 percent. The participants were 40 years of age and older and at risk for lung cancer because of a history of cigarette smoking, occupational exposure (to asbestos, beryllium, uranium or radon), or exposure to second-hand smoke."We believe this study provides compelling evidence that CT screening for lung cancer offers new hope for millions of people at risk for this disease and could dramatically reverse lung cancer death rates," said Dr. Claudia Henschke, the study's lead author and principal investigator who is chief of the chest imaging division at NewYork-Presbyterian/Weill Cornell and professor of radiology and cardiothoracic surgery at Weill Cornell Medical College. Questions and Answers
You are at risk if you are or have been a smoker. The risk increases with age. Other risk factors include exposure to environmental carcinogens, such as asbestos, or lung scarring.The I-ELCAP research has focused on patients at a high risk for lung cancer. Several factors contribute to lung cancer risk: age; smoking history; environmental exposure to carcinogens like asbestos, beryllium, uranium, or radon; and exposure to second hand smoke. The older you are, and the more you've smoked or been exposed to smoke and other carcinogens, the higher your risk will be.
The best hope for curing lung cancer is finding it as early as possible; the I-ELCAP research shows that annual CT screening can find 85% of lung cancers in their earliest, most curable stage. If you are at risk, a CT scan can detect tiny spots on your lungs (called 'nodules') that may indicate lung cancer in this early stage (New England Journal of Medicine 2006; 355; 1763-1771).
Advances in CT scanning now allow individuals to undergo a painless, non-invasive scan that takes about 20 seconds once you have registered, changed clothing and are on the scanning table. The entire process of registering and filling out our simple questionnaire can be completed in less than half an hour.
A radiologist who has had special training and is experienced in interpreting these types of tests analyses each CT scan. The radiologists will discuss any findings and necessary follow-up with the participant's Doctor.
Lung cancer results in more deaths in the United States than any other cancer; in fact, it accounts for more deaths than breast, cervix, colon, and prostate cancer combined.Because lung cancer has no symptoms in its early stages, more than 85 percent of the men and women who are diagnosed with lung cancer today are diagnosed in a late stage, after symptoms occur and when there is very little chance of cure. As a result, approximately 95% of the 173,000 people (USA figures) diagnosed each year die from the disease. With early detection, 85 percent of cancers can be found in the earliest, most curable stage. If treated promptly with surgery, their 10-year survival rate is 92% (New England Journal of Medicine 2006: 355: 1763-1771).
The research from I-ELCAP shows that patients diagnosed with lung cancer as a result of annual CT screening have an overall 10-year survival rate of 80%, regardless of stage and type of treatment. When cancers are found at the earliest stage (85% of the patients) and are immediately removed with surgery, the research shows a 10-year survival rate of 92%. The research involves over 31,000 patients who are considered to be at risk for lung cancer due to a combination of their age and histories of cigarette smoking, occupational exposure to carcinogens, or exposure to second-hand smoke (New England Journal of Medicine 2006: 355: 1763-1771).The initial findings of the ELCAP team, published in The Lancet, a prestigious medical journal, and on July 9, 1999 on the front page of The New York Times showed that 85% of the cancers that are found with CT screening are small and in the more curable early stage.Chest x-rays done at the same time failed to reveal 85 percent of the early-stage cancers detected by the CT scans. The ELCAP team also developed procedures and analytic techniques for highly accurate assessment of tumour growth, significantly reducing the chances of unnecessary additional tests and treatments.It was already well-known that small early stage lung cancers are much more curable than those found in later stages as 10-year survival rates of 90% or more had been reported by others.
Any smoker or ex-smoker over the age of 40 is eligible.
The screening CT scan is a low-dose scan, which means very little radiation is used. The radiation dosage is similar to that of a mammogram.
I’ve had chest x-rays before, why would I want to have this scan?A chest x-ray shows only two views of your chest (front and side), while a CT scan shows cross-sectional images all through your chest-from the very top of your lungs through the lung bases. Thus, tiny abnormalities (that could be early stage lung cancer) can be found which would never have been seen on a chest x-ray.
Yes. Old or new pneumonia, tuberculosis, or emphysema may be detected.
The benefits of lung cancer screening CT scans are highest for those with significant lung cancer risk. The I-ELCAP research has focused on patients at a high risk for lung cancer. Several factors contribute to lung cancer risk: age; smoking history; environmental exposure to carcinogens like asbestos, beryllium, uranium, or radon; and exposure to second hand smoke. The older you are, and the more you've smoked or been exposed to smoke and other carcinogens, the higher your risk will be.Additionally, a recent I-ELACP study showed that women were twice as likely as men to develop lung cancer when both had similar smoking histories.
Risks associated with being screened include finding abnormalities that need additional tests and that are ultimately benign. These tests can cause anxiety and on some occasions lead to invasive procedures such as biopsy to further determine whether a finding is a cancer. The I-ELCAP protocol has been frequently updated over the past 14 years to keep these risks at a minimum. This should be discussed with your doctor for further information.
The actual CT scan takes only about 5 minutes in total (with set up and scanning time). You are only scanned for less than 20 seconds, while you hold your breath. The registration and interview with the Coordinator may add an additional 25-30 minutes to your visit. We recommend setting aside one hour of your schedule for this appointment, even though it is unlikely that the entire hour will be necessary.
Smoking History: Greater than 10 pack years.(20 cigerettes for 10 years)Age: Older than 40Asymptomatic
