Controversies in Lung Cancer Screenings Put to Pro/Con Debate


Christopher Slatore

The National Lung Screening Trial (NLST) demonstrated a 20 percent relative reduction in lung cancer specific mortality with the use of annual low-dose CT scans. Current guidelines from the ATS and other organizations recommend that screening should be offered to those at high risk of developing lung cancer. The Centers for Medicare and Medicaid Services and other insurance providers now cover lung cancer screening. However, given the high false-positive rate, significant concerns remain about the harms of screening and whether the results of the NLST will translate to improvements in mortality among patients in routine clinical care. Most health systems are at various stages of developing screening programs.

The session “Controversies in Lung Cancer Screening: Pro/Con Debate” from 9:30 to 11:30 a.m. today in Room 605/607 (Street Level) Colorado Convention Center will explore the tradeoffs benefits and harms of screening.

“Lung cancer screening can provide benefit, but it can also cause harm. More people are harmed by screening than are helped, and one of the primary goals is to reduce the frequency and severity of that harm. Implementation decisions are very important for determining that balance of benefit and harm,” says Christopher Slatore, MD, co-leader for the Lung Cancer Screening Clinical Demonstration Project at the Veterans Affairs Portland Health Care System and assistant professor of medicine at Oregon Health & Science University.

Dr. Slatore is co-chair of the debate with Anil Vachani, MD, MS, assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine, Philadelphia, and Nichole Tanner, MD, MSCR, assistant professor of pulmonary, critical care, allergy, and sleep medicine at the Medical University of South Carolina, Charleston.

The speakers will discuss aspects of screening where the balance of benefit and harm may be altered, depending on how it is implemented.

“The pro/con format is designed to highlight different balances of risk and harm, but not provide simplistic answers for the right or wrong ways to implement screening,” Dr. Slatore says.

Presenters will provide pro and con perspectives for whether or not lung cancer screening should adhere to U.S. Preventive Services Task Force criteria, whether screening should be available at all centers, if biomarkers are ready for clinical use, and if overdiagnosis is a real problem.

“The topics are designed to provide a framework for how to weigh the benefits and risks about lung cancer screening implementation so that attendees can use them when designing their own programs,” Dr. Slatore says.

If this session interests you, don’t miss “Inflammatory Signaling Pathways Linking COPD and Lung Cancer: New Peaks on the Rocky Climb to a Cure” from 9:30 to 11:30 a.m. Wednesday in Room 605/607 (Street Level) Colorado Convention Center. Speakers will discuss novel insights into the biological links between COPD and lung cancer, the role of NF-kB pathway in carcinogen-induced lung cancer, the role of tumor-associated neutrophils in lung tumorigenesis, and cigarette smoke, COPD, and lung cancer.

“Controversies in Lung Cancer Screening: Pro/Con Debate” is supported by educational grants from AstraZeneca LP, Genentech, and Pfizer Inc.