The nonprofit organization Lung Cancer Alliance has criticized a U.S. government study that claimed CT scans yield twice as many false positives as chest x-rays and lead to a high percentage of invasive follow-up procedures.
The paper, which was published last week in the Annals of Internal Medicine, is based on the National Lung Screening Trial (NLST) performed in 2000 and 2001. That study used outdated equipment and failed to follow a uniform diagnostic protocol, according to the Lung Cancer Alliance.
"This repackaged data from a flawed 10-year-old study ignores the exponential advances in CT imaging that have been made since then, and fails to acknowledge the great progress that dedicated screening researchers in the United States and abroad have made and are continuing to make in perfecting the CT screening protocol," the Washington, DC-based organization said in a statement.
The Lung Cancer Alliance noted that it's not surprising that CT scans picked up more suspicious nodules in the study, as CT scanners are designed to be more sensitive and pick up smaller nodules that chest x-rays will frequently miss. The organization also emphasized the importance of a protocol for how nodules are evaluated, followed-up, and diagnosed.
"The [study] did not have a defined, uniform, well-considered procedure in place and, from a patient advocate perspective, showed the pitfalls of screening without a good diagnostic protocol," the organization wrote. "Indeed, every screening research trial since then has included one."
The Lung Cancer Alliance cited the first published papers on the Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON) trial and the International Early Lung Cancer Action Program (I-ELCAP) as examples of the use of a defined diagnostic work-up protocol and the benefits of CT lung cancer screening.
Related Reading
Lung cancer screening often yields false positives, April 20, 2010
CT-screened lung cancer patients live longer, May 11, 2009
NELSON lung cancer trial yields positive early results, March 9, 2009
CT screening catches small cell lung cancers earlier, February 10, 2009
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