TALL WOMEN AT HIGHER RISK FOR CANCER

Taller women have an increased risk of developing many types of cancer, compared with their shorter counterparts, according to new research published online today in the Lancet Oncology.
"For a woman of any height, the risk of cancer was 16% greater than for a woman 10 cm shorter. The association was seen across the whole normal range of heights," lead author Jane Green, DPhil, University of Oxford, United Kingdom, told Medscape Medical News.
"Other people have found links between height and some common cancers," Dr. Green said in an interview. "We had a study large enough to examine this link in detail for a range of cancers, and taking into account factors such as smoking and socioeconomic factors, so we were able to extend the previous findings."
Dr. Green and her team assessed the association between height and cancer incidence in the Million Women Study, in which close to 1.3 million middle-aged women in the United Kingdom were enrolled between 1996 and 2001. Their mean age at recruitment was 56.1 years.
Taller women tended to be of higher socioeconomic status, drink more alcohol, be older at first menstruation, have fewer children, be more active, and have their first child later in life than shorter women. They were also less likely to be obese or to be current smokers.
The mean height of the study population was 160.9 cm. The mean height of the tallest women was 174 cm and of the shortest women was 153 cm, for a difference of 21 cm.
The women were followed for a total of 11.7 million person-years, or a median of 9.4 years per woman (interquartile range, 8.4 to 10.2 years). During this time, 97,376 incident cancers occurred.
The study found that the relative risk (RR) for total cancer was 1.16 (95% confidence interval [CI], 1.14 to 1.17; P < .0001) for every 10 cm increase in height.
The increased risk was statistically significant for 10 different cancers.
RR for Individual Cancers per 10 cm Increase in Height

Cancer Type	RR	95% CI
Colon	1.25	1.19–1.30
Rectal	1.14	1.07–1.22
Malignant melanoma	1.32	1.24–1.40
Breast	1.17	1.15–1.19
Endometrial	1.19	1.13–1.24
Ovary	1.17	1.11–1.23
Kidney	1.29	1.19–1.41
Central nervous system	1.20	1.12–1.29
Non-Hodgkin's lymphoma	1.21	1.14–1.29
Leukemia	1.26	1.15–1.38

The researchers also conducted a meta-analysis, combining their results with those from 10 published prospective studies, and found that the height-associated risk of developing cancer was similar in Europe, North America, Australasia, and Asia.
Asked why she thinks taller people have a greater cancer risk, Dr. Green said: "Taller people have more cells in their bodies, so will have a greater chance of one of those cells developing cancerous changes."
She added that growth hormones, which have been linked both to childhood growth and to cancer, might also play a part.
So What's a Tall Person to Do?
"You can't change your height, nor would most people want to," Dr. Green said. "Being tall has health advantages, including lower risk of heart disease. The increased cancer risk is just part of the picture. Most people are not a lot taller or shorter than average, and their cancer risks will not be greatly affected by their height."
She added that the single most important risk factor for cancer is smoking, "and that is something that can be changed."
Dr. Green said her hope is that the results of this study will contribute to knowledge of how cancers develop.
In an accompanying comment, Andrew G. Renehan, PhD, from the University of Manchester, United Kingdom, writes that attained adult height is unlikely to directly modify cancer risk. He calls for future research to explore the predictive value of nutrition, psychosocial stress, and illness during childhood, rather than final adult height.
"Extended follow-up of large childhood cohorts with longitudinal repeated exposure measurements are needed," Dr. Renehan states.
"Assessing these cohorts will need new methods (e.g., latent class analyses) to tease out key factors that influence the subsequent development of height-related cancers," he concludes.
The study was funded by Cancer Research UK and the UK Medical Research Council. Dr. Green has has disclosed no relevant financial relationships. Dr. Renehan reports financial relationships with Novo Nordisk.

BENEFITS OF OVARIAN SUPPRESION DURING BREAST CANCER CHEMOTHERAPY-BAD TRIAL DESIGN

Temporary ovarian suppression during chemotherapy in young women with early-stage breast cancer reduced the occurrence of treatment-induced early menopause, according to Italian researchers.
In a phase 3 study, triptorelin, a gonadotropin-releasing hormone agonist (GnRH), was administered to suppress ovarian function during chemotherapy in the hope of protecting women 18 to 45 years of age from ovarian failure, say the authors, led by Lucia Del Mastro, MD, from the Istituto Nazionale per la Ricerca sul Cancro in Genova, Italy. They report their results in the July 20 issue of the Journal of the American Medical Association.
The exact mechanism through which this protection takes place is not known, admit the authors.
Nonetheless, patients randomized to the group that received chemotherapy plus triptorelin had a lower rate of early menopause than those randomized to the group that received chemotherapy alone, for an absolute difference of −17% (8.9% vs 25.9%; P <.001).
Early menopause was defined as either the failure to resume menses or to recover premenopausal levels of estradiol 12 months after the end of chemotherapy.
Triptorelin "can therefore be offered to premenopausal patients with breast cancer who wish to decrease the risk of permanent ovarian failure associated with chemotherapy," conclude the authors.
However, a pair of American breast cancer experts suggest that this conclusion is overreaching.
"Recovery of a single menstrual cycle or premenopausal levels of estradiol are not definitive measures of recovery of ovarian function," write Hope Rugo, MD, and Mitchell Rosen, MD, from the University of California San Francisco, in an editorial accompanying the study.
Furthermore, the editorialists note that a large portion (82%) of the study participants had hormone-receptor-positive disease. If these women recovered their menses after treatment with triptorelin, the study protocol called for the immediate use of 2 more years of ovarian suppression with triptorelin, in addition to 5 years of tamoxifen, to avoid the adverse effects of ovarian-produced estrogen on disease outcome. As a result, "it is impossible to evaluate the effects of ovarian suppression on true recovery of ovarian function or on ovarian reserve," they write. True recovery means long-term recovery, they suggest.
Another problem with the study and its approach is that other research suggests that loss of menses is helpful in the treatment of hormone-receptor-positive breast cancer, the editorialists note.
They point out that "recent data have confirmed that amenorrhea 12 months after the start of therapy had an important effect on outcome, with an almost 50% relative improvement in risk of recurrence or death in women with hormone-receptor-positive disease and amenorrhea, compared with those with persistent menstrual function" (N Engl J Med. 2010;362:2053-2065).
Because the current study has no information about disease outcome and because women with hormone-receptor-positive disease who had evidence of recovery were immediately resuppressed, per the study protocol (and thus cannot be counted as having long-term recovery of ovarian function), the editorialists believe too much is unknown about ovarian suppression with triptorelin.
Thus, the use of triptorelin is not wholly advisable in women with hormone-sensitive disease, they argue.
The current study — and mixed results from other, smaller studies on this subject — indicate that, for women with hormone-sensitive disease, "the use of GnRH agonists concomitant with chemotherapy cannot be recommended as a standard treatment and should be approached with caution," they write.
The Matter of Fertility
The study, known as PROMISE-GIM6 (Prevention of Menopause Induced by Chemotherapy: A Study in Early Breast Cancer Patients–Gruppo Italiano Mammella 6), was conducted at 16 Italian centers. Between October 2003 and January 2008, the investigators enrolled 281 patients who were premenopausal with stage I to III breast cancer.
Patients received adjuvant or neoadjuvant treatment with anthracycline-based chemotherapy, anthracycline plus taxane-based chemotherapy, or CMF-based chemotherapy (100 mg/m² of oral cyclophosphamide on days 1 to 14 or 600 mg/m² of intravenous cyclophosphamide on days 1 and 8; 40 mg/m² of methotrexate on days 1 and 8; and 600 mg/m² of fluorouracil on days 1 and 8).
The patients randomized to receive triptorelin (n = 148) were given an intramuscular dose of 3.75 mg at least 1 week before starting chemotherapy, and then every 4 weeks for the duration of the treatment, according to the authors.
Women with hormone-receptor-positive disease received 20 mg/day of tamoxifen for 5 years starting after chemotherapy ended.
Predictably, recovery of menses was less common in women receiving tamoxifen, and the protection with triptorelin from early menopause was greater in women with hormone-receptor-negative disease than in those with hormone-receptor-positive disease.
Multivariate analysis showed that only treatment with triptorelin was associated with a significant reduction in the risk of developing early menopause (odds ratio, 0.28; 95% confidence interval, 0.14 to 0.59; P <.001). Patient age and the type of chemotherapy (taxane- or CMF-containing) did not significantly affect the risk, report the authors.
Although the incidence of early menopause was the primary outcome measure, the investigators say that infertility is another major concern for these young women.
"Young survivors of breast cancer consider premature menopause, sexual dysfunction, and infertility the most distressing aspects of their cancer experience," write the authors, referring to chemotherapy-induced adverse events.
As a strategy to preserve fertility, ovarian suppression has a number of advantages over cryopreservation. It "does not require a male partner, is simple to administer, does not require delaying chemotherapy, and is less invasive and less expensive," the authors say. These 2 approaches to preserving fertility are "not mutually exclusive," they write, adding that "they can be used together to increase the probability of preserving fertility."
The editorialists agree that GnRH agonist therapy during chemotherapy can "potentially expand fertility possibilities." However, they point out that "recovering menses is not the same as fertility preservation." Instead, what matters most is "ovarian reserve," which is an end point that "clearly affects reproductive potential but is more difficult to measure." In short, the resumption of menses is a surrogate marker for fertility.
The editorialists champion reproductive technology for women in the "difficult situation" of being treated with chemotherapy for breast cancer. They write: "The most effective option for fertility preservation is assisted reproductive technology with embryo or oocyte cryopreservation, and this option should be discussed with young women facing chemotherapy for breast cancer and other curable malignancies."
This study was sponsored by the Istituto Nazionale per la Ricerca sul Cancro, and partly supported by a grant from the Associazione Italiana per la Ricerca sul Cancro, Italy. The triptorelin used in the study was provided by Ipsen (Milan, Italy). Dr. Del Mastro reports receiving honoraria for speaking activity from Ipsen. Another author reports receiving payment for lectures from AstraZeneca. Dr. Rugo reports that her institution has received research funding from Pfizer, Novartis, Roche/Genentech, Abbott, Celgene, Merck, and Bristol-Meyers Squibb, and she reports receiving honoraria from Genomic Health. Dr. Rosen has disclosed no relevant financial relationships.

GASTRIC CANCER STAGING

Tumor.
TX: The primary tumor cannot be evaluated.
T0 (T plus zero): There is no evidence of a primary tumor in the stomach.
Tis: This stage describes a condition called carcinoma (cancer) in situ. The cancer is found only in cells on the surface of the epithelium (the inner lining of the stomach) and has not spread to any other layers of the stomach.
T1: The tumor has invaded the lamina propria, muscularis mucosae, or the submucosa (the inner layers of the wall of the stomach).
T1a: The tumor has invaded the lamina propria or muscularis mucosae.
T1b: The tumor has invaded the submucosa.
T2: The tumor has invaded the muscularis propria (the muscle layer of the stomach).
T3: The tumor has grown through all of the layers of the muscle into the connective tissue outside the stomach, but it has not penetrated the peritoneal lining or serosa.
T4: The tumor has grown through all of the layers of the muscle into the connective tissue outside the stomach and has penetrated the peritoneal lining or serosa or the organs surrounding the stomach.
T4a: The tumor has invaded the serosa.
T4b: The tumor has invaded organs surrounding the stomach.

Node.
NX: Regional lymph nodes cannot be evaluated.
N0 (N plus zero): The cancer has not spread into the regional lymph nodes.
N1: The cancer has spread to one to two regional lymph nodes.
N2: The cancer has spread to three to six regional lymph nodes.
N3: The cancer has spread to seven or more regional lymph nodes.
N3a: The cancer has spread to seven to 15 regional lymph nodes.
N3b: The cancer has spread to more than 16 regional lymph nodes.

MX: Distant metastasis cannot be evaluated.
M0 (M plus zero): The cancer has not metastasized.
M1: The cancer has spread to another part or parts of the body.

Cancer stage grouping
Stage 0: This is also called carcinoma in situ.
Stage IA: T1N0M0
Stage IB: T1N1M0, T2N0M0
Stage IIA: T1N2M0, T2N1M0, T3N0M0
Stage IIB: T1N3M0, T2N2M0, T3N1M0, T4aN0M0
Stage IIIA: T2N3M0, T3N2M0, T4a, N1, M0
Stage IIIB: T3N3M0, T4a,N2M0, T4bN0N1M0).
Stage IV: any T, any N, M1

Do you really need 8 glasses of water a day?

How much water do we really need? You may think six to eight glasses per day because you have probably read many articles and had discussions with your doctor to support that. But a Scottish physician has blasted that standard in a British Medical Journalarticle, stirring the debate about how much water we should drink and how much is too much and bad for our health. Dr. Margaret McCartney argues there is no quality scientific evidence to support the recommendation, which she says can lead to over-hydration problems for some people.

Here's what you need to know to sort hydration hype from good health advice.

Don't skimp
The eight-glass formula doesn't fit for everyone. It depends on your gender, size, and level of activity, other studies note. The Institute of Medicine calls for adult men to drink 13 cups of fluid daily (which totals three liters, or a little more than four tall reusable water bottles) and women to have nine cups (2.2 liters, or about the amount found in three reusable water bottles). That number changes according to lifestyle. The more active a person is, the more they will need to replace fluids. Larger people, pregnant and nursing women, and those who take dehydrating medications also will likely need to account for that by adding more water to their diet.

If you are active, it's also important to account for your environment when calculating how much fluid you need. If you are exercising in temperatures that are very hot (likely leading you sweat more) or very cold (which can stunt your ability to sense dehydration), are an endurance athlete, or are active in a high-altitude area, you will probably need to up your water intake.

Don't overdo it
The debate about how much water we really need to be drinking is centered around the risk of hyponatremia, or taking in more fluid that the body loses while sweating. It is a serious condition that occurs when there is not enough sodium (or salt) in the body fluids outside of the cells. This can cause swelling, including of the brain. Hyponatremia happens when a person sweats excessively in one stint, does not eat, does not urinate enough, and drinks a great deal of water. Symptoms include confusion, headaches, muscle spasms, vomiting, convulsions, and fatigue. In the worst cases, hyponatremia can lead to seizures, coma, and even death.

There are exceptions for medical conditions and other situations, but athletes are often watched for signs of hyponatremia, especially those participating in endurance events like a marathon or triathlon.

Experts advise taking in some electrolyte-replacement fluids in addition to drinking water while you are exercising. However, you really only need a minimal amount to keep your body in balance and give you an energy kick. For example, it is recommended that runners out for 30 minutes to an hour take in three to six ounces of fluid every 15 or 20 minutes, including one sports drink. There's also evidence that simply taking sips or swishing a sports drink will do the trick.

Don't get sucked in to the sports drink hype
The risks of hyponatremia are steep, but take the hype about over-hydrating with a grain of salt. The multi-billion-dollar sports drink industry has pushed the idea that most people need more than water when they are active. However, some experts say that most people don't need a lot of sports beverages, and that they often just add calories to diets. The CDC recommends choosing sports drinks that do not have added sugar, which can total 38 grams in just one bottle.

Count other drinks besides water as fluids
It's OK to include other drinks when you're measuring how many fluids you take in per day. However, that isn't a license to subsist on soda, coffee, and sugary drinks. Although caffeine in soda and coffee won't dehydrate you, they shouldn't be used to quench thirst or as a substitute for water. Add them to your fluid tally, but do reach for water more often than you pop open a can of bubbly stuff.

People who imbibe, particularly wine and hard liquors, should also be aware that those drinks with a high alcohol content can be dehydrating. Beer, however, is less dehydrating because it is predominantly water. Drinking a glass of water before and after alcohol can't hurt fluid intake or the chances of avoiding a headache the next day.


Eat your water
You don't always have to sip to stay hydrated. Experts say that 20 percent (or 2-1/2 cups) of the water we ingest comes from the foods we eat. Choosing the right water-rich fruits and vegetables will also add nutrients to your diet, fill you up, and may even give some oomph to your exercise.

Fruits like strawberries, cantaloupes, and peaches are packed full of water and potassium, which is the electrolyte shed when your body sweats. Adding more to your daily diet will help balance the fluids your body needs, regulate your heartbeat and circulation, and tastes better than chugging an energy drink.

Selecting foods that fuel your health while helping keep you hydrated will give you more bang for your buck. Watermelon offers a vitamin C boost, broccoli helps fight cancer, pineapple aids muscle recovery after a big workout, and yogurt ups immunity. (Read more about foods that keep you hydrated and healthy here.)


Sneak in the good stuff
If you're up to your ears in cucumber salad or can't manage to down another bottle of water, work in little ways to stay hydrated. Add slices of orange, lime, kiwi, or watermelon to a jug of water for a burst of natural flavor. Make a regular old glass of tap water feel fancier by adding fizz with a counter-top carbonator (sold for about $100 and marketed as home soda-makers, skip the added flavors to make sparkling water in your own reusable bottles). Take 10 minutes once a week to stock your fridge, car, gym bag, and desk with water bottles so it's convenient to grab water wherever you spend most of your day. Finally, you can up your fluid intake with one little step by simply adding a straw to your glass of water.

LUNG CANCER SCREENING-TIME TO BEGIN

Results from the landmark National Lung Screening Trial (NLST), which indicate that screening with low-dose helical computed tomography (CT) reduces mortality from lung cancer, have been published online in the New England Journal of Medicine.
The 53,000-person trial found a 20% reduction in deaths from lung cancer among current and former heavy smokers screened with low-dose helical CT, compared with those screened with chest radiograph (P = .004); the study has a median follow-up of 6.5 years. These principal findings were first reported publicly in October 2010, and were covered at the time by Medscape Medical News.
The newly published paper includes previously unavailable details on the diagnostic procedures performed after positive screenings and their related complications rates, as well as details on the lung cancers that were diagnosed.
The study has been accompanied by expressions of enthusiasm and gratitude from the American oncology community.
"It's gratifying. We've been looking for this kind of good news in lung cancer for a long time," Otis Brawley, MD, chief medical officer at the American Cancer Society (ACS), told Medscape Medical News.
"This study fills a huge gap in lung cancer control," said Bruce Johnson, MD, in a press statement from the American Society of Clinical Oncology, where he is a board member. "This is a very exciting and important result," added Dr. Johnson, who is from the Dana-Farber Cancer Institute in Boston, Massachusetts.
The positive study results beg the question of whether or not it is time for lung cancer screening programs in the United States.
The study authors, led by Christine Berg, MD, from the National Cancer Institute, think the evidence is not complete enough yet. "The current NLST data alone are . . . insufficient to fully inform such important decisions [on lung cancer screening recommendations]."
The authors have estimated the immensity of the potential impact of such policies.
Although there are only 7 million adults in the United States who meet the entry criteria for the NLST, there are an estimated 94 million adults who are current or former smokers, and thus potential screens, they suggest.
Whatever the target population, "a national screening program of annual low-dose CT would be very expensive," writes Harold Sox, MD, from Dartmouth Medical School in West Lebanon, New Hampshire, in an editorial that accompanies the NLST study. "I agree with the authors that policy makers should wait for more information before endorsing lung cancer screening programs," he writes, citing cost as his principal objection.
However, one clinician has seen enough data to endorse screening.
"There should be a national screening policy, with CT offered to and even recommended for all patients who meet the same criteria as the eligibility for the NLST," said Howard West, MD, from the Swedish Cancer Institute in Seattle, Washington, and author of the Blowing Smokelung cancer blog.
If such a policy is not forthcoming, the lung cancer community, including medical professionals, "should ask the government and insurance company leadership why they so clearly devalue the lives of people with lung cancer, compared with those afflicted with other cancers," Dr. West toldMedscape Medical News.
Dr. West said that if results of this magnitude were seen in other cancers, especially breast cancer, there would be no questioning the cost of the screening. "Screening in other cancers that is widely accepted is based on far, far less impressive improvement in actual survival," he said.
"Our society routinely places a very different threshold for acceptance of lung cancer interventions than breast cancer interventions, which are often routinely and unquestioningly accepted as worthwhile interventions based on remarkably minimal absolute differences in outcomes," he pointed out.
"There is nothing less valuable about a life saved from lung cancer than a life saved from breast cancer or another cancer," said Dr. West.
Dr. Brawley suggested that professional opinion will influence forthcoming lung cancer screening policy. The ACS began drafting a lung cancer screening guideline when the NLST results were first announced. The ACS guideline will now be informed by the paper's new data, as well as by the medical communities' reaction to it, said Dr. Brawley. The ACS will be "monitoring the 'Letters to the Editor' reaction to the paper," he said.
Concerns About Harms
In NLST, participants were between 55 and 74 years of age and had a history of heavy smoking. They were screened once a year for 3 years, and were followed for 3.5 additional years with no screening.
There were 247 deaths from lung cancer per 100,000 person-years in the low-dose CT group and 309 deaths per 100,000 person-years in the radiography group, which is a relative reduction in mortality from lung cancer with low-dose CT screening of 20% (95% confidence interval [CI], 6.8 to 26.7).
The number needed to screen with low-dose CT to prevent 1 death from lung cancer was 320, Constantine Gatsonis, PhD, one of the study coauthors, told Medscape Medical News. He is from the Warren Alpert Medical School of Brown University in Providence, Rhode Island.
The rate of positive screening tests was more than 3 times higher with low-dose CT than with radiography (24.2% vs 6.9%) over all 3 rounds.
Most of the positive tests were false — 96.4% of the positive screening results in the low-dose CT group and 94.5% in the radiography group were false-positive results.
"The rate of false positives is very high, although the thoracic/pulmonology communities have certainly seen high rates of false positives with screening in the past," noted Dr. West.
The authors address the issue of false positives. "The vast majority of false-positive results were probably due to the presence of benign intrapulmonary lymph nodes or noncalcified granulomas," they write.
In a related concern, they note that the rates of complications after a diagnostic evaluation procedure for a positive screening test were "low." The rate of 1 complication or more was 1.4% in the low-dose CT group and 1.6% in the radiography group. The diagnostic methods and algorithms varied at the 33 sites and were not uniform per the protocol, the authors point out.
Dr. Sox observes that invasive diagnostic procedures were "few, suggesting that diagnostic CT and comparison with prior images usually sufficed to rule out lung cancer in participants with suspicious screening findings."
Dr. West said that lung screening is akin to prostate-specific antigen monitoring for prostate cancer. "Undergoing CT screening for lung cancer will require a careful discussion of the road that this may well lead people down, including the anxiety, additional imaging, and potentially invasive procedures that this pathway might well entail," he said.
The study authors point to another finding from the NLST as proof of the relative safety of lung cancer screening. The rate of death from any cause was reduced in the low-dose CT group, compared with the radiography group, by 6.7% (95% CI, 1.2 to 13.6; P = .02). "The decrease in the rate of death from any cause with the use of low-dose CT screening suggests that such screening is not, on the whole, deleterious," they conclude.
Another concern with CT screening is overdiagnosis, says Dr. Sox.
"Overdiagnosis probably occurred in the NLST," he writes. After 6 years of observation, there were 1060 lung cancers in the low-dose CT group and 941 in the radiography group. This may be evidence of overdiagnosis because, in a large clinical trial of screening tests, "the proportion of patients in whom cancer ultimately develops should be the same in the 2 study groups," he said. If the difference found to date between the 2 screening methods persists with more follow-up, this "suggests that one test is detecting cancers that would never grow large enough to be detected by the other test," Dr. Sox notes.
Finally, the study authors cite one last safety concern with CT screening — cancer caused by the CT scans themselves. "The association of low-dose CT with the development of radiation-induced cancers could not be measured directly," they write, adding that it is a "long-term phenomenon." Dr. Brawley said that previous research has indicated that for every 2000 spiral CT scans, there is at least 1 cancer caused (Radiology. 2004;232:735-738).
Cancers Detected
Low-dose CT screening fulfills an often-touted claim about cancer screening — that it detects more cancers earlier than would have been likely detected clinically. Indeed, 40% of the cancers in the low-dose CT group were stage 1A, whereas 21.7% were stage IV.
"Cancers discovered after a positive low-dose CT screening test were more likely to be early stage and less likely to be late stage than were those discovered after chest radiography," Dr. Sox explains.
Will the benefits of screening seen in the NLST be seen in community settings? Dr. Sox believes the applicability of the results is "mixed."
Diagnostic work-up and treatment did take place in the community, he acknowledged. "However, the images were interpreted by radiologists at the screening center who had extra training in the interpretation of low-dose CT scans and presumably a heavy low-dose CT workload," he writes.
Furthermore, both Dr. Sox and the study authors point out that the study population was not typical. Trial participants were younger and had a higher level of education than a random sample of men and women with a history of heavy smoking. This might have contributed to the high rate of adherence to the screening protocol in the study (more than 90%), says Dr. Sox.
The influential US Preventative Services Task Force (USPSTF) will make a determination about recommendations for lung cancer screening "by next year," said Dr. Brawley. In the meantime, while the USPSTF and organizations such as the ASC, which helped fund the study, and the American College of Radiology make their recommendations, physicians and patients should have a conversation about the harms and benefits of screening, he said.
Dr. Brawley, while emphasizing concerns about low-dose CT screening, said that "it's wonderful that we can say to high-risk people: 'We have something to offer you folks."
The study was conducted by the American College of Radiology Imaging Network and the National Cancer Institute's Lung Screening Study Group.