UCSF Joins National Study for Lung Cancer Screening

September 18, 2002
Contact: National Cancer Institute (301) 496-6641

About 90 million current and former smokers in the United States are at high risk for lung cancer. The release below describes a national study that UCSF Medical Center has joined to determine if screening smokers and former smokers with either spiral computerized tomography (CT) or chest X-ray -- before they have symptoms -- can reduce deaths from lung cancer. Participants will be enrolled in this study after Nov. 1. Dr. David Jablons, chief of General Thoracic Surgery, is the principal investigator at UCSF. Please call (415) 885-3882 for information about participating.

If you are a member of the news media, please call Eve Harris at (415) 885-7277 for more information.

The National Cancer Institute (NCI) today launched a new study to determine if screening people with either spiral computerized tomography (CT) or chest X-ray before they have symptoms can reduce deaths from lung cancer. The National Lung Screening Trial (NLST) will enroll 50,000 current or former smokers and will take place at a total of 30 sites throughout the United States.

To carry out the trial, NCI is using two research networks funded by the Institute: one network has been conducting the lung screening study called the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, and the other is the American College of Radiology Imaging Network (ACRIN), a network of researchers who conduct imaging studies. In addition, NCI is collaborating with the American Cancer Society to organize grassroots recruitment efforts at NLST sites.

"NLST is important because there an estimated 90 million current and former smokers in the United States at high risk for lung cancer, and death rates for this disease, unlike many other cancers, have not declined," said NLST co-director John Gohagan, Ph.D., of NCI's Division of Cancer Prevention. "Lung cancer kills more people than cancers of the breast, prostate, colon, and pancreas combined and will claim nearly 155,000 lives this year. Our hope is that this study will lead to saving lives."

To help ensure that NLST reaches full enrollment quickly, the American Cancer Society will support NCI with targeted promotional and outreach efforts in communities surrounding the trial sites.

"Reducing lung cancer deaths is a high priority of the American Cancer Society," said Harmon Eyre, M.D., chief medical officer and executive vice president for research and cancer control of the American Cancer Society. "With a recognized commitment to saving lives from cancer, and a trusted local presence near each of the NLST sites, the Society is uniquely positioned to communicate the benefits of the trial, build trust in eligible participants, and help NCI reach full enrollment as soon as possible."

The trial is a randomized, controlled study-the "gold standard" of research studies. Study participants will be randomly assigned-designated by chance-to receive either a chest X-ray or a spiral CT once a year for three years. Researchers will continue to contact participants annually to monitor their health until 2009.

When detected, lung cancer has usually spread outside the lung in 15 percent to 30 percent of cases. Spiral CT can pick up tumors well under 1 centimeter in size, while chest X-rays detect tumors about 1 to 2 centimeter in size.

"Conventional wisdom suggests that the smaller the tumor when it is found, the more likely the chance of survival-but that remains to be proven," said ACRIN researcher and NLST co-director Dr. Denise Aberle, from the University of California Los Angeles. "Because of the number of individuals participating and because it is a randomized, controlled trial, NLST will be able to provide the evidence needed to determine whether spiral CT scans are better than chest X-rays at reducing a person's chances of dying from lung cancer."

Spiral CT, a technology introduced in the 1990s, uses X-rays to scan the entire chest in about 15 to 25 seconds, during a single breath hold. A computer creates images from the scan, assembling them into a 3-dimensional model of the lungs.

More than half of the hospitals in the United States own a spiral CT machine and routinely use them for staging lung and other cancers -- that is, determining how advanced the cancer is after diagnosis. Recently some hospitals have begun performing spiral CT scans as a new way to find early lung cancer in smokers and former smokers. However, no scientific evidence to date has shown that screening or early detection of lung cancer with either spiral CT or chest X-rays actually saves lives.

In addition to the lung cancer screenings, some NLST centers will collect blood, urine, and sputum. These samples will be used for future research to test for biomarkers that may someday help doctors better diagnose lung cancer.

Participants in the study will receive lung cancer screenings free of charge. Men and women can participate if they meet the following requirements:

  • Are current or former smokers ages 55 to 74
  • Have never had lung cancer and have not had any cancer within the last five years, except some skin cancers or in situ cancers
  • Are not currently enrolled in any other cancer screening or cancer prevention trial
  • Have not had a CT scan of the chest or lungs within the last 18 months

Additional materials related to NLST include:

The National Cancer Institute is a component of the National Institutes of Health, U.S. Department of Health and Human Services.