NCI-Sponsored Study Finds Increased Risk of False-Positives in CT Lung Cancer Screening

May 13, 2010

Results of a new study published in the Annals of Internal Medicine [Ann Intern Med 152:505-512, 2010] indicate that the risk for false-positive results of CT lung cancer screening tests is substantial. Led by Jennifer M. Croswell, MD, researchers from NCI sought to quantify the cumulative risk in a 1- or 2-year lung cancer screening exam, based on at least one false-positive finding. In addition to determining the rates of false-positive findings, the investigators identified rates of unnecessary diagnostic procedures that are potentially brought on by these false-positive findings. The randomized controlled trial of low-dose CT vs chest radiography (ClinicalTrials.gov registration number: NCT00006382) found that the risks of false-positive results of lung cancer screening tests are substantial after only two annual examinations, particularly for low-dose CT. The authors recommended further study of resulting economic, psychosocial, and physical burdens of these methods.

by Frederic Grannis | August 05, 2010 4:12 PM EDT

There should be no surprise when badly designed research produces poor results. When you design a screening study without an effective diagnostic and treatment algorithm, as did the NCI investigators, an unnecessarily high risk of diagnostic procedures and operations may be expected. When lung cancer screening is performed in the context of a well-designed diagnostic and treatment algorithm, as in the case of the IELCAP study and European studies based upon the same protocol, the risk of invasive biopsy and operation is much lower.

When you dither and postpone population lung cancer screening while awaiting results from NCI trials, (results of the PLCO trial will be published in 2015, 23 years after the trial was started) you get not a risk, but a guarantee that 160,000 people will die in the U.S. next year and every year subsequently until screening is implemented.

When you screen high-risk smokers and ex-smokers using the IELCAP screening regimen, you can expect that 79% of patients diagnosed with lung cancer will survive at 10 years compared to 15% unscreened lung cancer patients.

Frederic W. Grannis Jr. M.D.

Long Beach CA

by celine martinz | May 23, 2010 12:17 AM EDT

So how does one know if their diagnosis is true or false. I feel my diagnosis of Metastatic leisons on the lungs after treatment and being cleared of Anal cancer is false as I feel no symptoms of cancer and in fact my lungs in the recent X'ray taken showed up clear. This taken to see if there was any fluid due to swolen feet. Please advise. I have no cough or pain in chest.

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NCI-Sponsored Study Finds Increased Risk of False-Positives in CT Lung Cancer Screening

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