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Source: McGill University

McGill-Cornell study: Screening, earlier treatment would substantially boost lung cancer survival

October 25, 2006

A groundbreaking international program guided by a McGill University researcher shows that proper screening followed by early treatment would dramatically reduce the number of deaths from lung cancer. Dr. Olli S. Miettinen, McGill professor in the Faculty of Medicine, Department of Epidemiology, Biostatistics and Occupational Health, and Department of Medicine, launched the research 13 years ago with a team of colleagues at the Weill Medical College of Cornell University in New York City, following his study design, which, for the first time, distinguishes between diagnostic and prognostic elements in screening research.

The results, published in the October 26 issue of the New England Journal of Medicine, indicate that lung cancer can be detected at its earliest stage in some 85 percent of patients using annual CT (computed tomography or CAT scan) screening, and that timely surgical treatment is curative in some 92 percent of these cases.

"Those Stage I diagnoses represented cases of genuine cancer," said Dr. Miettinen. "All of them were confirmed by a panel of internationally recognized experts on lung pathology; 95 percent of the lesions were already invasive; and in all of the eight instances in which treatment was refused, the patient died of lung cancer within five years."

The original study evolved into the International Early Lung Cancer Action Program (I-ELCAP), at present a collaboration among 38 institutions in seven countries and the largest, most comprehensive program of research on the issues surrounding CT screening for lung cancer. The work has been supported by numerous private and public grants, including from the U.S. National Cancer Institute (NCI) and the American Cancer Society (ACS).

Lung cancer remains the leading cause of cancer death among both men and women in Canada. The fatality rate associated with lung cancer remains dismally high, some 90 percent with lung cancer deaths more common than those resulting from breast, prostate and colorectal cancers combined. In the absence of screening, the vast majority of lung cancers are diagnosed in later stages, when they are no longer curable.

Among 31,567 persons in the program, CT screening led to the diagnosis of lung cancer in 484 individuals, to stage I diagnosis in 412 of them. Overall, the estimated cure rate for the 484 patients with lung cancer was 80 percent. All the participants were 40 years of age or older and at relatively high risk because of a history of cigarette smoking, occupational exposure (to asbestos, beryllium, uranium or radon), or exposure to environmental tobacco smoke.

Allison Flynn
McGill University



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