Statement of Dr. Norman H. Edelman, Chief Medical Officer, American Lung Association on Lung CT Scan

Finding the most efficient methods of diagnosing lung cancer is a critical element in early detection and treatment of the leading cause of cancer mortality in the United States. The article published in this week’s Journal of the American Medical Association underscores the American Lung Association’s position that the evidence is not yet clear enough that CT screening does more good than harm, as it exposes people to serious risks of injury and even death from needless surgery.

The American Lung Association Scientific Advisory Committee reviewed the science related to spiral CT screening for lung cancer and endorses the position, consistent with the federal government and professional societies, that the spiral CT method has not yet been proven beneficial as a screening method for lung cancer. We strongly endorse the current trial by the National Cancer Institute, (NCI) which is designed to determine whether screening high risk populations by this method is indeed beneficial.

The National Cancer Institute ongoing trial, the National Lung Screening Trial (NLST), is comparing two ways of detecting lung cancer: spiral computed tomography (CT) and standard chest x-ray films. Although both chest x-ray films and spiral CT scans have been used to find lung cancer early, neither test has been shown to reduce a person’s chance of dying from lung cancer. This study aims to show if either test is better at reducing deaths from this disease. It is important to note that this is a randomized, controlled study--the “gold standard” of research studies--and is large enough to determine if there is a 20 percent or greater drop in lung cancer mortality from using spiral CT compared to chest x-ray films. There is uniform agreement among professional societies that a clinical trial of sufficient power is necessary before we can endorse CT screening for lung cancer in high-risk groups.

Our ability to cure lung cancer has not improved as it has for other cancers, thus we definitely need to devote more attention to lung cancer research. In 1971, the 5-year survival rate for lung cancer was 13 percent. Today it’s only 15.5 percent. Clearly we can and must do better.

The American Lung Association stands firm in the fight to prevent lung disease and promote lung health. We urge government to allocate more federal funding to lung cancer research. Even if all smoking stops tomorrow, lung cancer will be a major health problem for decades. The estimated numbers of new cases in 2006 were 174,470, which is 12 percent of all cancer diagnoses. Research is urgently needed for effective early detection, protection for people at risk for lung cancer, and for better treatments.

The American Lung Association is putting resources into vital lung cancer research. We urge Congress to increase the investment in life saving research to prevent and cure all lung disease. We strongly support increasing funding for lung cancer research.