An article published in the Annals of Internal Medicine adds new fuel to the debate over the utility of lung cancer screening. The ongoing results of the National Lung Screening Trial from the National Cancer Institute are highly anticipated and many hope it will bring some clarity to this controversial topic. The full results won’t be available for another year or two, however this week’s publication provides a look at an important drawback of screening: false positive results. Preliminary results show that up to a third of all suspicious nodules found on CT scan were not actually cancer. For the patient, this means unnecessary anxiety, additional follow-up testing, and potentially risky and invasive procedures. Fundamentally, whether or not screening the benefits of screening justify these risks remains to be seen.
This story, in relatively few words, is notably strong in describing these risks, not only in quantitative terms, but in terms that are meaningful to someone considering screening.
Both CT scans and x-rays generate significant numbers of false positive results when used to screen for lung cancer. Patients should carefully consider the consequences of these tests before initiating screening.
The story clearly states the cost of a CT scan. The story could have commented on the fact that insurance may not cover it as a screening test.
Because the story focuses on the false positivity rate of CT scanning, it would not be necessary for it to also quantify the potential benefits.
The story is particularly strong in its description and quantification of potential harms from CT screening. Not only does the story quantify the percentage of false positive results, but it clearly and vividly describes what they mean to the patient.
The story does a good job of describing the current study, a large randomized trial from the National Cancer Institute.
The story could have been improved by quoting independent experts who could have provided more perspective on the importance of these findings.
The story compares CT scanning to conventional X-rays as a screening method.
CT scanning to detect and/or diagnose lung cancer is clearly widely available.
CT scanning to detect and/or diagnose lung cancer is not a new idea. Whether to use this technology to screen widely for lung cancer is a relatively new and highly controversial idea.
There is no way to know if the story relied on a press release as the sole source of information.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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