Lung cancer screening call for smokers

More than 40,000 lung cancers are diagnosed each year

Screening potential lung cancer sufferers for the disease could save many lives, says a report.But other experts say the high costs involved in screening smokers make such a programme unjustifiable.And, they add, the death rate could actually increase as the "safety net" factor made smokers more relaxed about their habit.The study, published in The Lancet, suggests that modern CT scanning is more likely to spot tumours than old-fashioned chest X-rays or sputum testing.Researchers screened 1,000 heavy smokers over the age of 60.

Survival depends on early detection

The stage at which lung cancer is diagnosed is critical in deciding whether the patient will survive.Most of the 27 cancers detected by the CT scan could be tackled by surgery, giving survival rates of 70% after five years.If the cancer has grown widely enough to rule out surgery, the survival rate can fall to less than 20%.

Smoking causes nine out of ten lung cancer cases

Dr Ian Smith, from the Royal Marsden Hospital in London, wrote in The Lancet: "We are nowhere near curing advanced lung cancer and the smoking legacy will be with us for a long time, whatever the outcome of prevention programmes."Lung-cancer screening with modern technology should again become a top research priority."However, there were problems with the CT scanning trial - although 27 patients actually had cancer, 223 scans were identified as possibly cancerous, but turned out to show benign nodules.

'Non-starter'

But a British Lung Foundation Expert said that the astronomical costs of scanning every heavy smoker once a year would be prohibitive.Dr Robin Rudd, who specialises in lung cancer, said: "Every CT scan costs between £250 and £450. Even if you could bring that down to £100, I think it is probably a non-starter in Britain at the moment."My guess is that it could cost as much as £100,000 for every life saved - for breast and cervical cancer screening it is much less."He suggested that large sums ploughed by the government into anti-smoking initiatives, such as the free nicotine patch plan announced in this week's public health white paper, would probably save more lives.

He said: "Screening gives people a false sense of security and may be counterproductive. We might well find the mortality rate goes up."Currently lung cancer, nine out of 10 cases caused by smoking, is the UK's most common cancer, with 42,000 new cases diagnosed each year, many of them fatal.

The breast and cervical screening programmes are currently the only two in the UK, although the effectiveness of screening for colon cancer and prostate cancer is being investigated.