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Cancer Study Finds Promise in CAT Scans for Smokers

Rating

4 Star

Cancer Study Finds Promise in CAT Scans for Smokers

Our Review Summary

This story reports on the results of a study on lung cancer screening published this week in the New England Journal of Medicine. Lung cancer is a common and deadly disease that can be effectively treated if caught early. Unfortunately by the time symptoms appear it is often too late for treatment to be effective. It would seem, therefore, that lung cancer would be a prime target for screening, much in the way that we already screen for breast cancer. On the surface, this study appears to indicate that all people at "high risk" (current or former smokers) could benefit from screening. But the reality is that the question of whether screening for lung cancer is effective remains to be answered. This story does a good job of representing what this new study tells us while providing the reader with the information needed to critically evaluate its usefulness.

The story adequately quantifies the benefits of treatment. Because this study had no control group, there is no way to directly compare screening to no screening, and the story explains that. Furthermore, the story rightly points out that the study looked at survival at 10 years as the outcome (although the study only followed patients for an average of 3 years and 10-year survival was estimated), not mortality, leaving open the question about whether or not screening actually extends life or if it only pushes forward the time of diagnosis (a situation known as lead-time bias).

The story mentions that abnormal scans can lead to biopsies and that the scans may pick up cancers that "grow so slowly they will never pose a health problem."  The story should have also mentioned radiation exposure as a potential harm and described the consequences of false positive test results.

The story does not discuss if the lung cancer screenings are available, or how widely available the screening scanners may be. The story should have mentioned that the tests are being advertised by private screening centers and some hospitals, but are not generally covered by insurance. The story also does not mention the cost of the test. Since most costs will be covered by the patient and not by the insurance company, this is vital information for the consumer.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention the cost of the test. Since most costs will be covered by the patient and not by the insurance company, this is vital information for the consumer.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story adequately quantifies the benefits of treatment. Because this study had no control group, there is no way to directly compare screening to no screening – and the story explains that. Furthermore, the story rightly points out that the study looked at survival at 10 years as the outcome (although the study only followed patients for an average of 3 years and 10-year survival was estimated), not mortality, leaving open the question about whether or not screening actually extends life or if it only pushes forward the time of diagnosis (a situation known as lead-time bias).

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentions that abnormal scans can lead to biopsies and that the scans may pick up cancers that "grow so slowly they will never pose a health problem."  The story should have also mentioned radiation exposure as a potential harm and described the consequences of false positive test results.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story adequately describes the design of the current study and, very appropriately, points out the limitations – that is, lack of controls and the use of 10-year survival as an outcome instead of mortality. These are very important caveats.

Does the story commit disease-mongering?

Satisfactory

By accurately describing the prevalence and seriousness of lung cancer, the story avoids disease mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story quotes multiple independent sources, providing much needed balance in the story.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions x-rays and no screening as alternatives to CT scanning.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The story does not discuss if the lung cancer screenings are available, or how widely available the screening scanners may be. The story should have mentioned that the tests are being advertised by private screening centers and some hospitals, but are not generally covered by insurance.

Does the story establish the true novelty of the approach?

Satisfactory

The story states that screening for lung cancer is not a new idea, but that screening with CAT scan is relatively new.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Because the story quotes multiple independent sources, the reader can assume the story did not rely on a press release as the sole source of information.

Total Score: 8 of 10 Satisfactory

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