18 Nov “These are lung cancer deaths averted with spiral CT
Why Some Doctors Hesitate To Screen Smokers For Lung Cancer
canada goose black friday sale In February, Medicare announced that it would pay for an annual lung cancer screening test for certain long term smokers. Medicare recipients between the ages of 55 and 77 who have smoked the equivalent of a pack a day for 30 years are now eligible for the annual test, known as a spiral CT scan. canada goose black friday sale
Medicare’s decision was partly a response to a 2011 study showing http://www.mycanadagoosejacket.org that screenings with the technique could reduce lung cancer canada goose outlet price deaths by 20 percent.
canada goose uk black friday That translates into thousands of lives each year, says Dr. Claudia Henschke, a radiologist who heads the lung and cancer screening program at canada goose jacket outlet New York’s Mount Sinai Medical Center. canada goose uk black friday
“It’s a tremendous step canada goose shop uk forward,” she says, primarily because lung cancer is canada goose jacket outlet store such a big killer. each year, more than the next three cancers breast, prostate and colon cancers combined.
canada goose store But as more and more people are getting screened for lung cancer, other doctors worry the test is doing more harm than good. canada goose store
“It’s the two canada goose outlet orlando edged sword,” says Dr. H. Gilbert Welch, a professor of medicine and health policy at the Geisel School of Medicine at Dartmouth. “The scans can see very early cancers,” Welch says, “but canada goose outlet online uk [can also] find cancers that were never going to matter.”
canada goose factory sale That’s canada goose outlet canada because some cancers grow slowly and never become dangerous, he says. Welch describes this phenomenon in his new book, Less Medicine, More Health: 7 Assumptions That Drive Too Much Care. canada goose factory sale
Welch says spiral CT scans also detect a lot of things that are not cancerous. Nearly a quarter of the 2011 study’s participants had multiple tests that showed abnormal growths in the lungs that turned out not to be cancer. These false positive tests led to more follow up testing, including risky procedures like a biopsy, which inserts a needle into the lung.
“Not surprisingly,” Welch says, “sometimes that creates problems like causing someone’s lung to collapse.”
buy canada goose jacket Welch is not claiming that that 2011 study, known as the National Lung Screening Trial, was bad science. Preventive Services canada goose outlet mississauga Task Force reviewed the data and determined that, overall, using the CT screening to find lung cancer does more good than harm. buy canada goose jacket
But Welch is concerned that the results of the study will not be replicated in the real world. In the study, he says, the radiologists were highly skilled at detecting lung cancer from a CT scan. The doctors were cautious, he says, and went to great lengths to avoid invasive tests like biopsies. Plus, the researchers clearly explained potential risks goose outlet canada to patients, including the high rate of false positives.
canada goose In everyday medical settings, Welch says, that won’t always be the case. canada goose
cheap canada goose uk “There are real reasons to be concerned that the harmful effects of the screening might actually be greater in practice,” he says. In other words, the net benefit of CT screening might not exist in the real world. cheap canada goose uk
Canada Goose Coats On Sale Dr. Andy Lazris canada goose outlet in chicago is an internist and primary care physician in Columbia, Md., and says his practice includes a lot of older smokers. He has looked carefully at the data and is not enthusiastic about using CT scans to look for lung cancer in his patients, most of whom are over 55. Canada Goose Coats On Sale
“Not many people are going to benefit,” he says. “A lot of people are going to get these false canada goose outlet online alarms and a lot of people are going to get excessive testing and potential harm.”
cheap Canada Goose To help his patients understand the odds, he shows them a picture of a theater seating diagram. cheap Canada Goose
Canada Goose Online “Out of a thousand seats in the theater, there are 3 1/2 blackened seats, which are barely visible,” he says, pointing at the diagram shown on the left. “These are lung cancer deaths averted with spiral CT. Canada Goose Online
canada goose coats Lazris says he shows the theater diagrams to many of his patients and gets a wide range of responses. Some patients, he says, point at one of the three blackened seats and say, ” ‘That’s probably me. I’m not taking any chances, I’m getting this test.’ ” canada goose coats
Canada Goose Parka “Other people,” he says, “will see [the same diagram] and will say, ‘Are you kidding me? I’m not going for that; canada goose outlet london that’s not worth it.'” Canada Goose Parka
uk canada goose outlet But in either scenario, Lazris says, he has done his job he has helped his patients understand the odds and then let them make the canada goose outlet seattle choice. uk canada goose outlet
Medical centers that canada goose outlet jackets screen Medicare patients are required to report their results to the government. Officials will be assessing each center’s performance and tracking patient outcomes to determine whether screening with spiral CT when expanded to a much larger scale is doing more harm than good.
Meanwhile, Dr. Henschke suggests that patients who are considering getting the screening canada goose womens outlet remember a couple of things.
First, they should discuss the benefits and risks with a primary care physician, she says. Medicare requires doctors to meet with patients before writing a referral, so patients should be sure they take advantage of this canada goose outlet legit opportunity.
canada goose clearance sale Also, Henschke says, patients should get the spiral CT done at a facility canada goose outlet black friday sale that has plenty of experience in screening people canada goose outlet woodbury for lung cancer “a place where you have a canada goose outlet team of people who are aware of what early lung cancer looks like.” canada goose clearance sale.