Lung Cancer Screening Using Helical CT vs. Chest X-ray Reduces Deaths among Current and Former Heavy Smokers

Computed tomography (CT) scan of the abdomen; drawing shows the patient on a table that slides through the CT machine, which takes x-ray pictures of the inside of the body.

Credit: Teresa Winslow (artist), for NCI

People with a history of smoking have a high risk of lung cancer – a disease with a five-year relative survival rate (for smokers and non-smokers combined) of only 15.8 percent.  Previous attempts at developing a test to find lung cancer early, when it is easier to treat, have not been able to demonstrate a decrease in mortality rates. Now, a study sponsored by the National Cancer Institute (NCI) has determined that low-dose helical computed tomography (CT) scans can reduce lung cancer mortality for current and former heavy smokers.  In the nation-wide study, which included over 53,000 participants, researchers found 20 percent fewer lung cancer deaths among those who were screened with low-dose helical CT (also known as spiral CT) compared with those who were screened with chest X-rays. In addition, deaths from all-causes (including lung cancer) were seven percent lower in those who received the low-dose helical CT scans.

“This is the first time that we have seen clear evidence of a significant reduction in mortality with a lung screening test in a randomized controlled trial.  The fact that low-dose helical CT provides a decided benefit will be a result that will have implications for the screening and management of lung cancer for many years to come,” said Christine Berg, M.D., NLST project officer for the NCI, in a press release.

In September 2002, the NCI launched the largest lung cancer screening study ever conducted.  The National Lung Screening Trial, or NLST, compared the effects of two lung cancer screening procedures, low dose helical CT and chest X-ray, in reducing mortality in current and former heavy smokers aged 55 to 74. Unlike previous trials, the NLST was a randomized control trial, the gold standard in clinical trials. Participants were randomly assigned to one of two comparable groups – chest X-ray or helical CT – and received three annual screenings based on their assigned technology.  The groups were followed for at least five years beyond the final screening. (Read an article in this publication from the launch of the trial in 2002)

“The results of this trial provide objective evidence of the benefits of low-dose helical CT screening in an older, high-risk population and suggest that if low-dose helical CT screening is implemented responsibly, and individuals with abnormalities are judiciously followed, we have the potential to save thousands of lives,” said Denise Aberle, M.D., NLST national principal investigator for ACRIN, in an NCI press release.  “However, given the high association between lung cancer and cigarette smoking, the trial investigators reemphasize that the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently.”

Low dose helical CT, which was introduced in the 1990’s, uses computer-controlled X-rays to scan the entire chest in about 7-15 seconds during a single, breath-hold. The CT scanner rotates around the person, who is lying still on a table as the table passes through the center of the scanner.

Two images depicting the difference between conventional and spiral CT scans. Conventional CT scans take pictures of slices of the body (like slices of bread). These slices are a few millimeters apart. The newer spiral (also called helical) CT scan takes continuous pictures of the body in a rapid spiral motion, so that there are no gaps in the pictures collected.

(Figure A:) Conventional CT scan. (Figure B:) Spiral CT scan. Credit: NCI Cancer Imaging Program

A computer creates images from the X-ray information coming from the scanner and assembles these images into a series of two-dimensional slices of the lung at very small intervals so that increased details within the organs of the chest can be identified.  Virtually all hospitals and free-standing radiology facilities in the United States now have a helical CT machine, which are routinely used for diagnostics. While some facilities do perform helical CT scans for the purpose of screening for lung cancer, such practice has not been previously supported by evidence and is not currently covered by most insurance providers.

Screening with CT scans comes with its own risks.  Radiation exposure from repeated CT scans can lead to illness, including cancer, and people who get false-positive results may be subjected to unnecessary surgical procedures.   It’s important to note that most abnormalities detected with CT screening are not cancer, even in people who are at high risk.

There are over 94 million current and former smokers in the United States who are at high risk for lung cancer.  In 2010, it is estimated that 222,520 people will be diagnosed with, and 157,300 will die from lung cancer, the leading cause of cancer death in the United States.

More information about the new results of the NLST is available in National Lung Screening Trial – Initial results: Questions and Answers and Fast Facts on NLST.  For more information on lung cancer and screening, please visit our Lung Cancer Homepage.

Print This Post Print This Post

43 Responses to “Lung Cancer Screening Using Helical CT vs. Chest X-ray Reduces Deaths among Current and Former Heavy Smokers”

  1. [...] This post was mentioned on Twitter by Anas Younes, M.D., Multicultural Media, Elin Silveous, Ntl Cancer Media Rel, Edward Winstead and others. Edward Winstead said: RT @BrookeLayne: Lung Cancer Screening Using Helical CT vs. Chest X-ray Reduces Deaths among Current and Former Heavy Smokers [...]

  2. says:

    Lung cancer trial results show mortality benefit with low-dose CT:Twenty percent fewer lung cancer deaths seen among those who were screened with low-dose spiral CT than with chest X-ray…

    Lung cancer trial results show mortality benefit with low-dose CT:Twenty percent fewer lung cancer deaths seen among those who were screened with low-dose spiral CT than with chest X-rayThe National Cancer Institute (NCI) is this day releasing initial …

  3. [...] This post was mentioned on Twitter by Yumiko MORII, 勝俣範之. 勝俣範之 said: NCIがヘビースモーカー 53,000 人のヘリカルCT検診のRCTで死亡率20%減少したことを発表。日本で過剰に報道されないことを祈る。日本ではこの結果が出る前からCT検診勧めてたし、それは科学的・倫理的によくないこと。 [...]

  4. Interestingly this blog, you could update it more often ..:)

  5. [...] and surgical removal can prolong the lives of patients.  Recent good news revealed by the National Cancer Institute-sponsored clinical trial with over 53,000 participants (mainly smokers and ex-smokers) has shown that a 20 % reduction of [...]

  6. After losing my mother in law to lung cancer because of heavy smoking, any improvement in the technology to save more lives would be great. Any one that does not have to experience what our family has gone through is doing the world a great service to all.

  7. ,:` I am really thankful to this topic because it really gives up to date information `-:

  8. I lost my father to Lung Cancer, and i think these things should be implemented whereever possible. I cant get my father back, and it was partly his fault for not going to the doctors that often, but maybe other people will be more fortunate in the future.

  9. It is evident by this article that advancements in medical technology are extremely essential if we want to save more human lives. Thanks for providing such up to date information.

  10. LiveJasmins says:

    I am a smoker for about 6 years. I hope that I will get rid of this bad habbit, mostly because of money, not health.

  11. [...] Considérant le phénomène hormetique, qui est une réponse positive à des faibles et très faibles doses (voir l’article ci-dessous: “The state of research on hormetic phenomena: the effects of low Radon doses”), nous pouvons énumérer les mesures préventives nécessaires pour gérer en toute sécurité les risques potentiels posés par le Radon, et passer d’un calcul de perte d’espérance de vie (LLE – Loss of Life Expectancy) à celui d’un gain  d’espérance de vie (GLE – Gain of Life Expectancy): a) Ventiler afin de réduire la concentration de Radon dans l’air, b) filtrer l’air des particules fines, auquelles les sous-produits de désintégration se fixent (par ex.: PM10 et le fumée de cigarette) c) se soumettre à un traitement de radiothérapie préventif à de faibles doses, tels que le “low-dose helical CT screening“ [...]

  12. A really usefull article – Thank you very much I hope you dont mind me blogging about this article on my blog I will also link back to this post Thanks

  13. Very very great medical infomation. My Mom and Dad is also very heavy smokers. Definitely need to get them to low-dose CT to check for lung cancer. Fast Computer Repair Sydney

  14. It’s important to remember that tobacco is one of the strongest cancer-causing agents, and quitting smoking can lower a person’s risk. Tobacco use is associated with a number of additional cancers, besides lung cancer, as well as with chronic lung diseases and cardiovascular diseases. The damage caused by smoking is cumulative and the longer a person smokes, the higher the risk of disease. However, if a person quits smoking, the damage may be partially reversible. Finally, many participants in the trial died of lung cancer despite receiving CT screening. NCI has information about stopping smoking, and resources that may be useful to your parents at

  15. This really hits home for me, being a smoker of 27 years i can truely vouch for those that wish to quit but just cant seem to kick the habit. Recently i just took aggressive steps in order to quit and i have been dreading going in to get my lungs checked to see what the damage is. Obviously i know that this technique is not available everywhere but its good to know that it is out there and eventually it will make its way into the mainstream.

    Great post thank you : )

  16. Richard says:

    Smoking is very addicting due to the levels of nicotine that are in cigarettes and rarely do we want to admit or see the damage we cause to ourselves and others by smoking. They also contain many harmful chemicals which add to the poison of our system. Growing up in a household I watched my father smoke and cough and choke and just couldn’t figure out why you would do that to yourself.

  17. new building says:

    I hope to kick the smoking, which causes death

  18. allen says:

    The information on this website is based on evidence from research on stop smoking programs, stop smoking aids and counseling, which are aimed at helping people to quit smoking for good. For those who want to stop smoking better start now. Think of your family. Secondhand smoke can kill them. Be aware of how life can give you.

  19. John dowson says:

    Thank You for this post. Just found it on google and i have to say that i;m really really surprised :)
    Thanks again and cheers dude!

  20. Julia Stone says:

    Thank you for sharing this article, İt is really Helpful, Thanx/3/26/2011 4:31:08 PM

  21. Nick says:

    In my profession I have watched people and their families suffer dearly due to smoking.The smoker shrivels away and dies and the family and kids have to watch it happen helplessly.BAD NEWS!

  22. Chris says:

    I really wish that more cancer research like this will be done. I lost someone close to me to cancer, and we really need more robust screening methods for all people around the world to help prevent this dreadful disease.

  23. vagi says:

    thanks to share these great information
    im very interested in reading.

    thanks very mush

  24. yiannis says:

    Im very pleased to hear this. This is really nice :).

  25. xxx says:

    I hope to kick the smoking, which causes death

  26. The best thing to do is to have a friend or relative stay with you to perform tasks that may involve any of the aforementioned movements. If you’ll be spending your breast surgery in Houston USA recovery time alone, plan ahead by doing the bulk of the cleaning before surgery day and make or buy microwavable meals for easy food access and less time spent out of bed.

  27. I smoked for 12 years and I stopped one day. It’s three years now I am not smoking and I am very happy. The problem is that many companies don’t want you to stop smoking us they earn every time you try to. So everyone tells you that it’s so hard to quit. Forget it, it’s not, you have to believe nad you win.

  28. Cancer says:

    friend WITHY cancer gone LOST hello all, a two-time cancer RELICT friend of WELL GAIN gone LOST. Mark Bosworth GAIN been missing

  29. Jupiter Insurance says:

    I have been a smoker for 25 years, and I never knew the disease had such a low five-year relative survival rate. I really need to quit ASAP.

  30. Cool says:

    “In the nation-wide study, which included over 53,000 participants, researchers found 20% fewer lung cancer deaths among those who were screened with low-dose helical CT (also known as spiral CT) compared with those who were screened with chest X-rays.”
    Great news!

  31. down syndrome facts says:

    nice article, lung cancer is an awful disease

  32. matt says:

    When will people learn their lesson, that smoking is a terrible thing to pick up on?!

  33. Cigarette Rolling says:

    Everyone should get screened with this machine. It seems very helpful.

  34. Wendy says:

    Machines like this should be distributed world-wide. People should be more conscious about their health and should have a routine yearly check-up. After losing a loved one from cancer (breast cancer), hearing news about early detecting device for some other forms of cancer is enlightening.

  35. Tobacco me is connected with a quantity of more types of cancer, in addition to united states, as well as using persistent lung diseases as well as aerobic ailments. The injury a result of smoking cigarettes will be final as well as the extended an individual smokes, the larger the risk of illness. Nonetheless, if a person gives up smoking cigarettes, the harm may be partly relatively easy to fix

  36. Heck if you’re a lung cancer get the checkups. That is unless you really don’t care. I remember when I was a kid there were cigarettes called death. They had a skull and crossbones on them. At least it’s honest.

  37. Max says:

    I have no clinical evidence to back this up but I found it easy to quit smoking after I had made the move to smoking roll-your-own cigarettes. Whether this is down to what cigarette manufacturers put into the pre-rolled variety I am in no position to say, but for me it required very little in the way of willpower to quit the roll-your-owns.

  38. Alexis says:

    I was a smoker for 7 years – then decided to quit after I realised how crap it was for me and my pocket…

  39. Lung cancer took my mom in law last year. Please stop smoking!

  40. masrawy says:

    nice post I smoked for 40 years and I stopped. It’s ten years now I am not smoking and I am very happy and healthy

  41. my dad had cancer and believe it or not he never sought treatment and never uttered a word about his condition. He was even matter of fact about going off to hospital when he knew he wouldn’t return.

  42. I hate those machines..I have been In them before.

  43. travelkhana says:

    thanx for sharing this information

Leave a Reply