Results of lung cancer trial have exciting implications

The fight against lung cancer continues, and data from a recent study indicates the tide could be turning.

Results from a large-scale test of screening methods to reduce deaths from lung cancer by detecting cancers at relatively early stages have exciting implications for Kentuckians, says the director of the James Graham Brown Cancer Center at the University of Louisville Health Sciences Center.

The National Cancer Institute's National Lung Screening Trial followed more than 53,000 current and former heavy smokers ages 55 to 74 and compared the effects of two screening procedures for lung cancer: low-dose helical computed tomography (CT) and standard chest X-ray. The data, in early November, showed 20 percent fewer lung cancer deaths among trial participants screened with helical CT.

Donald Miller, M.D., Ph.D., who has headed the Brown Cancer Center since 1999, said the results, "though preliminary, are terribly exciting."

"For the first time, we have rigorously tested evidence to support the use of CT as an effective screening method to prevent death from lung cancer among those at highest risk for it – smokers," Miller said. "This development is likely to change the practice of medicine."

Lung cancer is the leading cause of cancer deaths in the U.S., and a 2008 analysis by the Centers for Disease Control and Prevention of 2.4 million cases of tobacco-related cancer found that Kentucky leads the nation in lung cancer rates among both men and women.

More than 3,400 Kentuckians die each year from lung cancer.

Speaking during a break from the Brown Cancer Center's Ninth Annual Research Retreat, Miller said the new study dovetails well with the work being conducted by center physician-scientists.

"We have a major effort in research into lung cancer biomarkers, and this new study goes hand-in-hand with the work we are already doing in early detection,” Miller said. "We will continue to review the data coming from this study and look at the longer follow-up rates to determine how best to integrate low-dose helical CT into our treatment protocol.

"This data show, for the first time, that doing so can make a difference in reducing deaths from lung cancer."

Miller emphasized, however, that the new data do not give smokers "a free ride to continue smoking."

Although smoking rates have decreased in Kentucky – from 31.6 percent in 1996 to 28.6 percent in 2006, the latest figure available – Kentuckians continue to be among the leading users of tobacco in the U.S.

"Obviously, the best way to prevent death from tobacco-related cancer is to never start using tobacco, or if you start, to quit as soon as you can,” Miller said. "We do know, however, that any approach that leads to a decrease in lung cancer deaths by 20 percent has great potential to save hundreds of thousands of lives over the course of time."

The James Graham Brown Cancer Center is a key component of the University of Louisville's Health Sciences Center and U of L Health Care. As the region's leading academic, research, and teaching medical center, patients benefit from the latest medical advances, often long before they become available in non-teaching settings.

The Brown Cancer Center is affiliated with the Kentucky Cancer Program and the National Cancer Institute.