It’s a tough call because doctors disagree and insurance doesn’t pay for the test, so if you do opt for it, you’ll be paying out of pocket — around $300.
In October, The New England Journal of Medicine published a massive study of more than 30,000 current and former smokers and came to a provocative conclusion: The noninvasive screening, which can catch lung cancers very early, was linked to a projected 88 percent 10-year survival rate if patients are treated promptly with surgery — dramatically better than the usual survival rate because lung cancers are rarely caught that early.
At first glance the implication of the new study, done by Dr. Claudia Henschke, a radiology professor at Weill Cornell Medical College in New York, seems like a no-brainer: Get screened if you’re at high risk for lung cancer, meaning you’re a current or former smoker who smoked at least half a pack a day for years and years.
But it’s not quite that simple. In part because it had no control group, the Henschke study “cannot answer the question of whether screening reduces deaths from lung cancer,” said Dr. Phillip Boiselle of Beth Israel Deaconess Medical Center.
A different, ongoing study, the National Lung Screening Trial, should be able to answer the question of whether CT screening truly saves lives, but those results won’t be available until 2009 at the earliest.
There are also risks to CT screening, said Dr. Michael Thun , who heads epidemiological research for the American Cancer Society. Among other things, the test is so sensitive that it can pick up small nodules that might not turn out to be life-threatening cancer but could result in unnecessary biopsy, surgery, and the attendant risks from bleeding, infection, and anesthesia.
So here’s my take: If I were a policymaker or an insurance company executive, I’d say CT screening is not ready for prime time. But if I were a smoker, first I’d work harder to quit. Then I’d talk to my doctor about getting tested. The Henschke study, though not perfect, is too important to ignore.