Lung cancer. Screening, counseling, and treating long-term smokers.
Survival of patients with lung cancer is approximately 12%, largely because the disease is not detected until it has reached an advanced stage. Past screening trials using chest X-ray and sputum cytology were unable to demonstrate a decrease in lung cancer mortality in the screened population. Recent reports document the ability of low-dose spiral CT scans to detect lung cancer at an earlier stage (nodules as small as 5 mm versus 10 mm for chest X-ray). These initial results suggest that CT screening may improve survival and decrease mortality. Therefore, physicians should consider discussing lung cancer screening using spiral CT scans with selected high-risk individuals (60 years and older with at least 10 pack-years of cigarette smoking and no other malignancies). At the very least, all patients who smoke should be counseled to quit and offered proven pharmacotherapies.
Wisnivesky
Juan P
JP
Mount Sinai School of Medicine, New York, NY, USA.
Szwarcberg
Javier B
JB
McGinn
Thomas G
TG
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D008403:Mass Screening; D008875:Middle Aged; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*