When the findings from the National Lung Screening Trial (NLST) came out in 2011, there was much excitement about the potential for low-dose computed tomography (CT) scans to save lives among people with lung cancer. The study found people who received low-dose CT scans had a 15 to 20% lower risk of dying from lung cancer than people who received standard chest X-rays. But results from clinical trials such as NLST don't always translate into real-world medicine, says Samir Soneji, Ph.D.
With an American Lung Association Lung Cancer Discovery Award, Dr. Soneji will study what patients know about lung cancer screening. "The grant will help us to understand not only if they are aware of CT screening, but what the potential benefits and risks are, so they can make an informed decision about whether to pursue screening," he says.
Dr. Soneji will also assess whether the people who can most benefit from screening are the people receiving CT scans. Those who can be helped the most are people who have a long history of smoking, but who are still young enough and healthy enough to benefit from surgery if the screening reveals they have early stage lung cancer. "If their cancer is too advanced, and has spread beyond the lung, surgery would not be a viable treatment option," says Dr. Soneji, Assistant Professor at the Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center in Hanover, New Hampshire.
He will use data from a survey that asks thousands of adults questions about their health, including their knowledge of lung cancer screening. He will also look at complication rates of lung biopsies and lung cancer surgery, and follow patients to see if they were hospitalized or died from complications of surgery. From the findings, Dr. Soneji will be able to conclude how beneficial CT scanning may prove to be in the community.
The findings can help improve the effectiveness of screening, he says. "The study will tell us where the barriers are in lung cancer screening and, consequently, where to focus our efforts to improve the quality of screening. If adult smokers demonstrate low knowledge about screening, public health messages can better inform them about the clear benefits of quitting smoking and potential benefits of screening. On the other hand, if complication rates from lung cancer surgery are high, then quality improvement initiatives at hospitals will improve outcomes for newly diagnosed lung cancer patients."
Page last updated: March 2, 2020