A recent study conducted by Dutch researchers suggests that early detection of lung cancer in older smokers through computed tomographic screening is more effective than quitting smoking. The study found that the earlier the diagnosis, the better the chance that the multitude of treatment options available to lung cancer patients will be successful. This method of detection can also lead to cost savings in the healthcare system. Lung cancer is the leading cause of cancer-related deaths in the U.S. and worldwide, causing more deaths than breast, colorectal, and prostate cancers combined.
Recent findings from a university research team in the Netherlands suggest that smokers over the age of 60 derive more benefit from a CT scan to prolong their life compared to a smoking cessation program. Associate Professor Carlijn van der Aalst of the Erasmus MC University Medical Center in Rotterdam stated that using a CT scan to detect lung cancer early is five to ten times more effective than offering a smoking cessation program, potentially saving up to ten years of life. While quitting smoking is beneficial, its effectiveness in preventing the development of lung cancer is limited among older individuals who are already at a higher risk.
The Dutch research team conducted a clinical trial involving over 13,000 high-risk male individuals randomly assigned to volume-based, low-dose CT screening in the Netherlands. A smaller number of high-risk women also participated in the trial. The study showed significantly reduced lung cancer mortality among those who underwent CT screening compared to those who did not. The effects of screening were more favorable for women than for men. Findings were published in the New England Journal of Medicine.
Following the publication of these findings, the Erasmus Medical Center in Rotterdam conducted a large-scale pilot survey among the at-risk group. The study was part of a demonstration project in which 400,000 people were invited to participate. Other European nations such as Germany, Spain, Italy, and France have also embarked on similar demonstration projects to assess the effectiveness of CT screening for lung cancer. In the U.S., guidelines published by the U.S. Preventative Services Taskforce recommend lung cancer screening for high-risk individuals between the ages of 50-80 with a 20 or higher pack-per-year history of smoking.
People over the age of 60 have the highest risk of developing lung cancer, partly due to starting smoking in their teenage years. Additionally, there is a socioeconomic element to lung cancer incidence, with lower-income populations facing a higher risk due to higher rates of smoking and poorer overall health. Dutch clinicians found that lung cancer occurs more frequently among the lowest-earning men in the Netherlands. At present in the Netherlands, CT scans for lung cancer are only performed when individuals present with symptoms that may be related to the disease.
Van der Aalst and other Dutch researchers are advocating for the implementation of routine population screening for lung cancer among high-risk groups, similar to screenings for colorectal and cervical cancer. They recommend carrying out a CT scan every two years for individuals above a certain age with risk factors such as smoking history. The Dutch Health Council, an independent scientific advisory body, is preparing to offer its advice on introducing routine lung cancer screening in the Netherlands. Early detection of lung cancer through low-dose CT screening has been shown to decrease mortality rates among high-risk populations in the U.S. and Europe.
