Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Spiral CT scan shows promise for discovering lung cancer at an early stage

Dr. W. Michael Alberts, chief medical officer and lung cancer specialist at H. Lee Moffitt Cancer Center and Research Institute in Tampa, shows the results of a CT scan of lung tissue.


Dr. W. Michael Alberts, chief medical officer and lung cancer specialist at H. Lee Moffitt Cancer Center and Research Institute in Tampa, shows the results of a CT scan of lung tissue.

Ask just about anyone which cancer is most lethal and you're likely to hear breast, pancreatic, perhaps colon or melanoma. Few people realize that lung cancer causes more deaths annually than several cancers combined, according to the Centers for Disease Control and Prevention.

Smoking is by far the leading cause of lung cancer in the United States, but for reasons not fully understood, 10 to 20 percent of lung cancers occur in people who have never smoked.

"It's difficult to fathom," says Dr. W. Michael Alberts, chief medical officer and lung cancer specialist at H. Lee Moffitt Cancer Center and Research Institute in Tampa. "Studies tell us it's a different disease in nonsmokers, a different branch of the lung cancer tree. It tells us everyone should be watchful."

One of the biggest problems with lung cancer: no screening test for early detection. By the time symptoms show up, it is usually advanced and has spread throughout the body; chances for a cure are slim. Early lung cancers are usually picked up by an X-ray or CT scan taken for an unrelated health issue.

An ideal screening test finds a disease in its earliest stages, before it produces symptoms — but it also saves lives. Breast cancer has mammography; cervical cancer has the Pap test; colon cancer has the colonoscopy.

But a screening test for early lung cancer remains elusive.

Researchers have considered chest X-rays and sputum tests that look for cancer cells in saliva; neither has been shown to prevent lung cancer deaths.

One test, however, holds some promise: the spiral CT scan or spiral computed tomography, which uses X-rays to scan the chest in a matter of seconds.

The patient lies on a table and a large doughnut-shaped scanner rotates around the body. A computer uses information from the scanner to produce a three-dimensional picture of the lungs; different colors can be assigned to specific features within the body, making for a detailed image. Some machines can detect tumors smaller than a grain of rice.

Earlier this month, the National Cancer Institute released new results from a large clinical trial that showed using spiral CT scans in smokers and former smokers decreased lung cancer deaths by 20 percent.

That's good news and serves as the first glimmer of hope for a reliable screening test for the leading cancer killer in the country.

"The images are superb," says Dr. Reed Murtagh, a diagnostic radiologist and professor of radiology and oncology at Moffitt.

But it is not without risk. "The radiation dose is high, really high," Murtagh said. "That has to be weighed against the benefits."

Plus, CT scans are expensive, from several hundred dollars up to $1,000 each, and they are not always covered by insurance. Even more problematic, the scans are so sensitive they pick up benign abnormalities like scars from past infections such as pneumonia. The NCI estimates that 25 to 60 percent of spiral CT scans of smokers and former smokers show noncancerous lesions. That can lead to unnecessary, potentially risky procedures like biopsies or even major surgery.

"How do we differentiate between scars and tumors?" Alberts asks. "False positives are a big problem."

That's why doctors are still cautious about ordering spiral CT scans and only recommend them for the highest-risk patients, such as long-term, heavy smokers. Scientists are trying to find a low-dose scan that gives similar detail and the same excellent pictures, Murtagh said.

Meanwhile, doctors say the best defense against lung cancer is to never smoke or stop smoking now. And familiarize yourself with the symptoms of lung cancer: a persistent cough; coughing up blood; persistent dull, aching chest pain; shortness of breath; wheezing; and hoarseness.

Irene Maher can be reached at


The National Lung Screening Trial

Began: 2002

Conducted at: 33 U.S. sites

Enrolled: 53,000 current and former heavy smokers

Compared: chest X-ray screening to spiral CT

Screened: once a year for 3 years

Findings: 442 lung cancer deaths with chest X-ray; 354 with spiral CT

At risk: 94 million current and former smokers in the United States

Source: National Cancer Institute

Spiral CT scan shows promise for discovering lung cancer at an early stage 11/24/10 [Last modified: Wednesday, November 24, 2010 6:01pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Kriseman invites Steph Curry to St. Pete on Twitter


    Mayor Rick Kriseman is no stranger to tweaking President Donald Trump on social media.

    Mayor Rick Kriseman took to Twitter Saturday evening to wade into President Donald Trump's latest social media scuffle
  2. Death toll, humanitarian crisis grow in Puerto Rico


    SAN JUAN, Puerto Rico — A humanitarian crisis grew Saturday in Puerto Rico as towns were left without fresh water, fuel, power or phone service following Hurricane Maria's devastating passage across the island.

    Crew members assess electrical lines in the aftermath of Hurricane Maria on Friday in Puerto Rico. Mobile communications systems are being flown in but “it’s going to take a while.”
  3. N. Korea says strike against U.S. mainland is 'inevitable'


    North Korea's foreign minister warned Saturday that a strike against the U.S. mainland is "inevitable" because President Donald Trump mocked leader Kim Jong Un with the belittling nickname "little rocketman."

  4. All-eyes photo gallery: Florida State Seminoles loss to the N.C. State Wolfpack


    View a gallery of images from the Florida State Seminoles 27-21 loss to the N.C. State Wolfpack Saturday in Tallahassee. The Seminoles will face Wake Forest on Saturday, Sept. 30 in Winston-Salem, North Carolina.

    Florida State Seminoles fans sing the fight song during the Florida State Seminoles game against the North Carolina State Wolfpack on September 23, 2017, at Doak Campbell Stadium in Tallahassee, Fla.  At the half, North Carolina State Wolfpack 17, Florida State Seminoles 10.
  5. Helicopter, small aircraft collide at Clearwater Air Park


    CLEARWATER — Two people suffered minor injuries after a helicopter and a small aircraft collided late Saturday afternoon at Clearwater Air Park, 1000 N Hercules Ave.

    Clearwater Fire Department emergency personal douse a plane with fire retardant after the plane crashed into a helicopter at Clearwater Air Park 1000 N Hercules Ave. Saturday, Sept. 23, 2017. According to Clearwater Fire two people sustained minor injuries. [Photo by Clearwater Fire Department]