Monday, November 15, 2010

Breaking News for SMOKERS

Last week we had an encouraging development for smokers- the National Cancer Institute prematurely stopped a study because they felt ethically obligated to let all the participants know that a low dose CT scan of the lungs as a screen for lung cancer was yielding a 20% decrease in mortality (as compared with screening chest xrays). What does this mean? Should every smoker get a lung CT scan?

Hold your horses- CT scans for all smokers is NOT the answer- though I wish it were that simple. What we know so far is that in this group of smokers, which was an older group that had a greater than 30 pack-year smoking history (smoking a pack per day for 30 or greater years), the CT scans apparently allowed earlier detection of lung cancers, enough that they had a significant (20%) decrease in deaths.

Over the years I have had many patients who smoke ask for annual screening chest xrays. I explain to them that this is NOT a good screening method, though often I have ended up ordering the xray, in the hopes that they might at least see some noncancerous damage from the smoking that might be enough to motivate them to QUIT. Now, however, we may be changing our recommendations, at least for the older smoker with an extensive smoking history.

Ultimately, though, the real answer is to never start smoking, and if you ARE smoking at ANY amount, find help asap to QUIT!
I'll spend more time this week discussing smoking cessation, but know that there are seven medical aids available through your physician that can help you quit for good.

BOTTOM LINE: Smokers with a greater than 30 pack-year history of smoking may indeed benefit from CT lung scans to detect early lung cancer- check with your doctor (and QUIT TODAY!!!)

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