A new study based on data from a National Cancer Registry in Taiwan has found that lung cancer screening may lead to overdiagnosis at the population level. The United States Preventive Services Task Force recommends lung cancer screening only for those individuals who have smoked an average of one pack of cigarettes per day for 20 years and are in age group of 50 to 80. But, in other countries like Taiwan, lung cancer screening for non-smokers has become popular.
The researchers from Brigham and Women’s Hospital and collaborators from Taipei Medical University has found that the number of early-stage cancer diagnoses has increased many fold among women but there was no change in incidence of advanced lung cancer or death from lung cancer over the past 15 years. This suggests that screening leads of overdiagnosis. The results from the study are published in JAMA Internal Medicine.
Lead author, H. Gilbert Welch, MD, MPH, of the Brigham’s Center for Surgery and Public Health, said, “Promotions for lung cancer screenings in Taiwan feature images of young women and dramatic language encouraging people to avoid the tragedy of sudden death from terminal lung cancer.” The study has found that while increased screening led to an increase in early diagnoses in young women but it has not led to decrease in late-stage cancers or deaths. So, this suggests that screening only leads to overdiagnosis and not to better outcomes.
The team looked at data from Taiwan’s National Cancer Registry and assessed rates of early and late-stage lung cancer diagnoses. The team estimated that about 7000 to 12000 Taiwanese women were overdiagnosed with lung cancer. Also, the incidence of advanced-stage lung cancer remained unaltered. They also note that the main limitation of their study was that they could not directly measure LDCT screening. Their results suggest that LDCT should only be offered to heavy smokers and only after the benefits have been weighed against the harms.
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