System will enable Mayo Clinic to achieve tenfold improvement in imaging for patients

ROCHESTER, Minn. — Mayo Clinic has installed a new PET/CT scanner that will dramatically improve imaging quality and speed for patients, especially for the diagnosis and treatment of cancer.

The Biograph Vision Quadra PET/CT scanner is the first in North America approved for clinical use, and will be scanning patients at its location in Rochester later this year. Mayo Clinic will be the first medical center in North America to offer patients advanced diagnostic imaging using a 106-centimeter-long PET/CT with ultrafast timing resolution, resulting in the most sensitive PET/CT scanner available for clinical use.

With this new scanner, Mayo Clinic can dramatically increase the quality and speed of clinical PET/CT scanning, while at the same time reducing radiation exposure to patients. This scanner can image the patient from the top of the head to the legs simultaneously, which allows Mayo Clinic physicians to think differently and implement new approaches to identifying disease for the care of patients — approaches that are not possible with shorter and older PET/CT scanners.

Mayo radiologists anticipate that they will use this PET/CT scanner to improve the staging of cancer, and diagnosing infection as well as inflammatory, cardiovascular and neurologic diseases. This scanner will allow for the development of:

• Systemic imaging capable of detecting very tiny sites of active cancer
• Accurate calculations of the amount of radiopharmaceutical therapy that can be delivered to sites of cancer in a patient-specific manner
• Whole-body 3D maps of quantitative blood flow rates to every organ and tissue
• Scanning with more than one PET radiotracer simultaneously

"This new scanner is literally an order of magnitude more powerful than our prior best PET/CT scanners, allowing for dramatic improvements in clinical practice while also opening whole new horizons," says Geoffrey Johnson, M.D., Ph.D., chair of the Division of Nuclear Medicine in the Department of Radiology at Mayo Clinic.

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About Mayo Clinic Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. For information on COVID-19, including Mayo Clinic's Coronavirus Map tracking tool, which has 14-day forecasting on COVID-19 trends, visit the Mayo Clinic COVID-19 Resource Center.

Media contacts:

• Ethan Grove, Mayo Clinic Public Affairs, newsbureau@mayo.edu

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When Rita Krueger found out she had pancreatic cancer, the outlook seemed bleak. Then she met a Mayo Clinic physician who was willing to go beyond the standard treatment to achieve remarkable results.

In more than half of people diagnosed with pancreatic cancer, the disease has already advanced to stage 4 before they notice any symptoms. But for Rita Krueger, a bothersome symptom was the catalyst for her diagnosis.

A persistent, intense itching prompted Rita to make a doctor's appointment, and in short order, testing revealed that she had pancreatic cancer. The quick diagnosis didn't seem to matter much at first, however, then a surgeon told Rita to get her affairs in order.

But a second opinion and a more aggressive approach to treatment at Mayo Clinic turned that outlook around. Today, Rita is doing well, and she's eager tell others about her experience.

"I want to talk about this, so I can change people's lives in a positive way," Rita says. "Because pancreatic cancer can be so fatalistic, I want to give people hope and let them know that they have options."

Frightening news

When Rita went to see her primary care doctor in Lino Lakes, Minnesota, to find the cause of her itching, bloodwork showed that she had developed diabetes, and results of her liver tests were abnormal. Those findings, coupled with her skin discomfort, were ominous signs.

"Weight loss, itchy skin and new-onset diabetes — these are three red flags that you have pancreatic cancer," says Mark Truty, M.D., a Mayo Clinic hepatobiliary and pancreatic surgeon.

Rita's local doctor recommended she undergo an MRI. The imaging revealed a tumor in Rita's pancreas, and it showed that her intense itching was due to the fact that the tumor was blocking one of her bile ducts. At that point, Rita was referred to a surgeon for a consult.

When she walked into the surgeon's office in February 2018 to discuss options to remove the tumor, Rita says she was not prepared for the conversation that followed. "I expected him to tell me he was going to do the surgery, and I could move on with life," Rita says. "Instead, he assumed it was cancer and told me to get my affairs in order. I remember sitting in his office crying. That was the first fatalistic conversation anyone had had with me."

"I've been a very healthy person all my life, so this was a big shock."

Rita Krueger

Rita underwent an endoscopy procedure to biopsy the tumor and place a stent in the blocked bile duct. Six days later, she received terrible news. "They confirmed I had pancreatic cancer," she recalls. "I've been a very healthy person all my life, so this was a big shock."

Rita and her husband, Jim, decided to go to Mayo Clinic in Rochester for a second opinion. On March 23, 2018, they met with Dr. Truty. A friend had told Rita about a high school classmate who Dr. Truty treated for pancreatic cancer and was cancer-free.

"I read that (Dr. Truty) had lost his father to this disease and made it his mission to help others have a better outcome. I felt like he was the dragon slayer of this disease," Rita says. "He was so confident, and he'd had such good success. I felt a peace and a confidence when I went to see him. I trusted him."

Stubborn foe

After meeting Rita and Jim, and reviewing her situation, Dr. Truty learned that Rita's tumor had grown outside of the pancreas, and it involved veins and arteries that supply and drain the pancreas and go to the liver. That made her condition complicated. But Dr. Truty had a plan.

"This would be a very complex surgery that would only be beneficial if we could remove the tumor and not leave cancer cells behind," Dr. Truty says. "Our approach was to do chemo first to kill the microscopic cancer cells that we know most people have circulating, but we can't see on any imaging."

Typically, patients with other types of cancer undergo a CT scan at the end of chemotherapy to determine if the tumor has shrunk. But that imaging isn't as helpful with pancreatic cancer. "One of the hallmarks of pancreatic cancer is that the cancer cells are embedded in a large amount of fibrosis, which makes penetration of the chemotherapy difficult," Dr. Truty says. "It also makes it difficult to discern the actual amount of living cancer. Therefore, CT scans aren't very predictive of whether the chemotherapy was beneficial or not, since the tumor doesn't always shrink."

"Because of this imaging, we're open to taking on more complex operations than might be the case at other centers."

Mark Truty, M.D.

Because of that, Mayo Clinic employs positron emissions tomography (PET) scanning combined with MRI imaging to determine how active the cancer is prior to chemotherapy. The test is repeated afterward to see if the activity has significantly decreased. "This is not often performed elsewhere and has revolutionized how we run our practice," Dr. Truty says. "Because of this imaging, we're open to taking on more complex operations than might be the case at other centers."

In April 2018, Rita began a three-drug combination chemotherapy that is one of only two regimens that have significant benefit for pancreatic cancer. After two months, however, a tumor marker blood test, a CT scan and a PET scan all showed that the tumor had not responded to the treatment.

Dr. Truty put Rita on the second chemotherapy regimen. Several months later, tests showed no evidence of a response. He then recommended radiation therapy five days a week for five weeks, beginning in August. In mid-September, Dr. Truty repeated all the tests.

"Unfortunately, the tumor was the same size and just as active, despite all our efforts," Dr. Truty says. "I had an otherwise healthy and vibrant 53-year-old woman in front of me who was very scared and would require a significantly complicated operation. Statistically, however, it didn't seem like she would do well with surgery."

After extensive discussions with Dr. Truty about the risks and benefits, and after praying about it, Rita decided she would move forward with surgery.

Excellent results

Rita underwent the 10-hour procedure on Oct. 23, 2018. Dr. Truty took out her pancreas, duodenum, spleen and left adrenal gland. He also removed and reconstructed several blood vessels that were involved in the tumor mass.

Two days after the surgery, the pathology report showed stunning results. There was no cancer left in Rita's tumor.

Part of the reason for that was a condition that had previously remained hidden. "The whole time we were seeing the tumor not changing or responding, it was because she'd developed severe pancreatitis," Dr. Truty says. "A PET scan, despite its significant benefit in assessing response, can't perfectly differentiate between inflammation of the pancreas and cancer. This was a wonderful surprise. Immediately, she was catapulted into a much better than average outcome."

"I really feel grateful that I've been given a second chance. I don't think I would be alive today if I hadn't gone to Mayo."

Rita Krueger

One of the major predictors of survival in people who undergo surgery after extensive chemotherapy is the amount of viable tumor found in the surgical specimen. People who have very little or no living cancer left in the tumor tend to do well long-term.

Rita was able to leave the hospital 19 days after surgery. In January 2019, she went back to her work as a software engineer full time. Because she had her pancreas removed, she now has to take insulin throughout the day. She also has to take pancreatic enzymes with her food to aid with digestion. But overall, she is doing well and feeling good.

"I really feel grateful that I've been given a second chance. I don't think I would be alive today if I hadn't gone to Mayo," Rita says. "Dr. Truty is a remarkable man and an innovative doctor who pushes the envelope. He and his team have given me a chance to be more intentional about how I live my life."

Dr. Truty credits Rita for being willing to persevere through all that was required to get her to that positive outcome. "She trusted me, and I trusted her. We both trusted our faith in order to make the right decision. We were on this journey together. And this was the right thing to do," Dr. Truty says. "I saw her two weeks ago, and all the scans looks pristine. She's getting back to life, and that's the whole point of this: to get some more time."

Watch this video to learn more about treatment for pancreatic cancer at Mayo Clinic:

HELPFUL LINKS

• Read more about pancreatic cancer.
• Check out the Mayo Clinic Cancer Center.
• Connect with others talking about pancreatic cancer on Mayo Clinic Connect.
• Explore Mayo Clinic.
• Request an appointment.

The post Aggressive Approach to Pancreatic Cancer Yields Outstanding Outcome appeared first on Mayo Clinic News Network.

What researchers found was that long-term quitters — pack-a-day smokers who stopped more than 15 years ago — and also those age 50 to 54, have a similar risk of lung cancer death as those which meet the national criteria.  

Researchers say the findings highlight the need to update the screening criteria when determining who is at high risk for lung cancer and should be screened.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network." Read the script.

Screening for lung cancer with an annual low-dose CT scan saves lives, and is recommended for those at high risk. The U.S. Preventive Services Task Force defines that as a person who is age 55 to 80 and smoked a pack a day for at least 30 years, or quit smoking within 15 years.

Dr. David Midthun (MID-toon), a Mayo Clinic pulmonologist and critical care specialist, says calculating a person's risk for lung cancer and screening recommendations isn't one-size-fits-all.

"Maybe they stopped smoking at 28 pack years. Maybe they are younger — age 50 — but have two siblings who died of lung cancer or have COPD (chronic obstructive pulmonary disease)," says Dr. Midthun.

He recommends considering additional factors. And age isn't strictly 55 and older.

"We include people who are perhaps a little younger than that, have a little less smoking history than that, but have other risk factors, such as COPD, family history, personal history of cancer," says Dr. Midthun.

And experts emphasize that education about lung cancer screening availability is especially important.

"Fewer people died of lung cancer in those who are screened with CT," says Dr. Midthun.

The post Mayo Clinic Minute: Who is at high risk for lung cancer? appeared first on Mayo Clinic News Network.

This image is not a medical illustration. It’s actually an enhanced CT scan that is as aesthetic as it is instructive. The patient had previously undergone coronary artery bypass surgery. You can see the connection points of the grafts to the aorta. Clips and wires used by the surgeon are also visible. The bypass grafts are successful; the image indicates that blood is flowing through them. Read more about Mayo’s research into rheumatoid arthritis and heart disease, heart transplant research, and stem cell therapy after heart attack. (This article appeared on Discovery's Edge.)

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Other Mayo Clinic medical research websites:

• Research at Mayo Clinic
• Discovery’s Edge
• Advancing the Science
• Forefront
• Mayo Clinic Center for Individualized Medicine
• Center for Regenerative Medicine
• Center for the Science of Health Care Delivery

The post Science Saturday: The heart of art appeared first on Mayo Clinic News Network.

ANSWER: While there are wide-ranging benefits to modern X-ray imaging technology, you are correct that there also are risks. The answer to your question isn’t clear-cut, so it’s important to weigh the potential risk against the known benefits of medical imaging.

Medical imaging uses radiation to generate images of the inside of your body. It can provide a quick and painless diagnosis or guide treatment, such as determining artery-opening stent placement.

The use of X-ray imaging has increased dramatically over the past 30 years, mainly due to technical advances and an increased use of CT and positron emission tomography (PET) scans. Likewise, the average amount of lifetime radiation exposure also has increased. The downside is that radiation can cause damage to, and mutation of, DNA. This might lead to the development of certain cancers.

Radiation is naturally present in the environment, coming from sources such as the sun and radon in rocks and soil. The average annual exposure in the U.S. from all sources of natural radiation is estimated to be about 3 millisieverts per person. However, you may be exposed to more or less depending on where you live. Exposure from natural radiation varies from 1 to 20 millisieverts in the U.S.

It’s estimated that the average annual amount of radiation exposure — a combination of natural and medical exposure in the U.S. — has roughly doubled since the 1980s to about 6.2 millisieverts. This value is an average over the entire population. If you haven’t had any medical exams that use radiation, your radiation exposure has not increased.

It’s not known at what levels radiation begins to significantly increase cancer risk. Below 100 millisieverts, an increase in risk has not been shown to exist. However, by scaling the risk at higher doses down to lower doses, it has been estimated that 10 millisieverts of radiation exposure could increase the lifetime risk of an adult dying of cancer by about 0.05 percent. With a 21 percent overall lifetime risk of dying of cancer, 10 millisieverts of radiation exposure theoretically could raise the lifetime risk of dying of cancer to 21.05 percent. This is a small amount considering the benefits of medically needed imaging tests.

Because the potential for an increased risk of cancer due to medical exams using radiation is small, there’s no reason to forgo an imaging test or X-ray-assisted procedure that could better your health or prolong your life. This is especially true for older adults, as potential radiation-caused cancer development may not occur for decades.

Also consider that CT and positron emission tomography scanners in use today use a much lower radiation dose than was used even just a few years ago. Radiation doses are further kept to a minimum when the dose is tailored specifically to body size and diagnostic requirements.

Still, radiation experts generally err on the side of caution. They assume that there’s no risk-free level of radiation exposure and recommend only medically necessary imaging tests.

To keep medical radiation exposure to a minimum, ask if the results of a scan or test are likely to change the course of your treatment. If not, it may not be necessary. If you switch health care providers, have image files transferred over to your new provider to avoid repeat X-ray exams. Finally, if the test is medically necessary, have the imaging done at a nationally accredited imaging center when possible. (adapted from Mayo Clinic Health Letter) — Dr. Patricia Mergo, Radiology, Mayo Clinic, Jacksonville, Florida

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• Women’s Wellness: Molecular breast imaging published 10/11/18
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• Researchers identify method to overcome false positives in CT imaging for lung cancer published 5/15/18
• Women’s Wellness: Comparing breast imaging tools published 11/30/17
• Mayo Clinic Minute: A better look at prostate cancer published 9/21/17
• Mayo Clinic Q and A: Comparing breast imaging tools published 4/4/17

The post Mayo Clinic Q and A: Weighing the benefits, risks of imaging tests that use radiation appeared first on Mayo Clinic News Network.

As a lifelong smoker, Sue Franken had resigned herself to the unhealthy habit. But that changed when Sue followed through on a promise she made to her sister.

Toward the end of her 47-year relationship with cigarettes, Sue Franken hated them. She feared being stigmatized by her co-workers and neighbors, so she hid her smoking. And because she didn't smoke in her home, stepping outside to feed her addiction became an unpleasant chore, especially during cold Minnesota winters.

The Rochester resident was well aware of the risks smoking posed to her health. She also knew her mother, sister and children wanted her to stop. But earlier this year, Sue was given the most compelling reason to quit. At the request of her sister, Christie, Sue underwent a low-dose CT scan through the Mayo Clinic Lung Screening Program. The test and evaluation that followed revealed Sue had early stage lung cancer.

"The knowledge that I had lung cancer, it just made me sick to my stomach every time I took a drag," she says.

With help from Mayo Clinic's Nicotine Dependence Center, Sue was able to stop smoking. After surgery to remove the tumor in her lung, now she's also cancer-free. Looking ahead, Sue is elated about the prospect of a healthy, smoke-free future.

"I'm thankful I don't have this crutch," says Sue, who’s replaced her unhealthy habit with the healthy practice of walking. "I've gained a couple of pounds because I did a lot of sitting around after surgery. But my sister says, 'We'd rather have you pudgy than smoking. We're not through with you yet.' And my answer to her is that I'm not through with me either."

Saved by screening

Sue began smoking when she was just 15 as a result of peer pressure, she says. At the time, alcohol could be legally purchased at the age of 18, and while she was still in high school, Sue began to drink, too.

"That was the worst thing that happened to me because, apparently, I have an addictive behavior, and I got hooked on alcohol," Sue says. "I've been sober for 20 years, but I made sure I went to a treatment center where I could still smoke."

Sue tried to quit smoking once before using the prescription medication varenicline, which helped curb her cravings. The stresses of life proved to be a greater force than the medication, though, and she gave up. But she often wondered about the toll her habit was taking on her health.

"I didn't have a regular cough, and I hadn't been sick with a cold for a number of years. But every once in a while I'd cough with some sputum, and that would make me think about what could be going on," Sue says. "I'm also a dancer. If I'd go out dancing and get short of breath, I'd think about it."

"Most lung cancer is picked up at an advanced stage, and if you wait until it becomes symptomatic, the cancer is usually pretty advanced and not very curable at that point." — Shanda Blackmon, M.D.

While her loved ones had hinted that she should stop, lack of any worrisome symptoms deterred her from seeking testing. Had Sue waited for shortness of breath or a persistent cough to occur, her outcome would have been vastly different, according to Shanda Blackmon, M.D., Sue's surgeon in Mayo Clinic's Department of Thoracic Surgery.

"Most lung cancer is picked up at an advanced stage, and if you wait until it becomes symptomatic, the cancer is usually pretty advanced and not very curable at that point," Dr. Blackmon says.

That Sue’s lung cancer was an invasive adenocarcinoma, a kind of cancer known to spread rapidly, made her sister’s encouragement all the more significant.

"Sue was reluctant to come in for screening, and her sister talked her into coming,” Dr. Blackmon says. “I believe her sister pretty much saved her life."

When the nodule was discovered in February via the Lung Screening Program, Sue's health care team wasted no time proceeding with treatment. On April 6, surgeons removed a 9-millimeter, stage 1 adenocarcinoma from Sue's right lung.

For at least five years, Sue will undergo yearly surveillance checkups for cancer recurrence. Among individuals who receive an early lung cancer diagnosis and tumor removal, Dr. Blackmon says there is a 2 percent chance of having a second, new lung cancer diagnosis each year for the next five years.

Improving survival

Since its inception in 2014, Mayo's Lung Screening Program has tested more than 4,500 patients. Of the first 1,000 patients screened, only about 20 were recommended for further testing, and 14 of those were diagnosed with lung cancer, says the program director, David E. Midthun, M.D., in Pulmonary Medicine.

"Of the ones we found, the staging was much earlier than typical," Dr. Midthun adds. "If you look at the survival rates for stage 1, it's still clear that it's much better from a survival standpoint to find these in the early stage.

What's more, studies show that compared to X-ray imaging, the low-dose CT scan used for lung screening is more effective at detecting abnormalities. The low-dose imaging technology also ensures patients are only exposed to as much radiation as is necessary to complete the imaging test.

But although going through the process of being checked for early stage lung cancer is important, ditching the smoking habit completely remains crucial, according to Dr. Midthun.

"For individuals at the highest risk — those 55 and over who’ve smoked 30 or more years — screening has been shown to save lives from lung cancer," he says. "Yet quitting smoking will save more lives from prevention of lung cancer and heart disease than from getting scanned."

Sharing her story

Sue says that when she first received her diagnosis, she was hesitant to break the news to Christie.

"I let my daughters and son and some of my girlfriends know, but I had a difficult time telling my sister because, in some respects, I was ashamed," Sue says. "That wasn't the first time she'd hinted that it would be great if I wasn't a smoker. But when I called her after I'd gotten my news, it was comfortable. She asked me to keep in touch with the rest of the story and that she'd be there for me."

"Although there is a stigma that comes with having lung cancer — that you got it because you deserve it — I’ve never met someone who deserved lung cancer." — David E. Midthun, M.D.

Just as her sister placed no blame on Sue for her diagnosis, neither did any of the providers she encountered at Mayo Clinic, Sue says.

"Although there is a stigma that comes with having lung cancer — that you got it because you deserve it — I’ve never met someone who deserved lung cancer," Dr. Midthun says.

With her diagnosis and treatment in the rearview mirror, the embarrassment Sue felt about her habit has been replaced with enthusiasm about sharing her story. She did just that with a TV interview filmed at Mayo Clinic.

"It was very powerful," Sue says. "And Dr. Blackmon was interviewed to get the message out there that asking someone to get that scan is the most important thing you can do to save a life."

HELPFUL LINKS

• Learn more about the Mayo Clinic Nicotine Dependence Center.
• Read about Mayo Clinic's Lung Screening Program.
• Explore Mayo Clinic.
• Request an appointment.

The post A Sister’s Love Saves A Life appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — With questions lingering about the safety of medical imaging and the radiation that is used in some of those tests, Mayo Clinic radiation safety expert Cynthia McCollough, Ph.D., wrote a paper that provides clear answers that she hopes will allay patients’ fears.

Dr. McCollough wrote “Answers to Common Questions About the Use and Safety of CT Scans,” which was published Oct. 1 in Mayo Clinic Proceedings as a Q&A in an effort to provide credible, balanced information about how much radiation a CT scan delivers and what levels are considered safe.

So, are CT scans safe? Yes, says Dr. McCollough.

Patients can get a prescribed CT scan without worrying, Dr. McCollough says. “Radiation has a bad rap. The Incredible Hulk and Spider Man were mutants created from some radiation exposure; that’s science fiction. The truth is we are all exposed to radiation every day of our lives, with no evidence that those low doses cause any long-term harm.”

Journalists: Sound bites with Dr. McCullough are available in the downloads.

MEDIA CONTACT: Ethan Grove, Mayo Clinic Public Affairs, 507-284-5005, email: newsbureau@mayo.edu

Areas that have higher background radiation levels (e.g., from the sun and radon in the ground) have lower cancer rates. If there is a cause and effect, it’s simply too small to measure. And, because of increased research and updates in technology, less radiation also is used these days in medical imaging.

“Over the past decade, the radiation doses used in CT have been cut by almost a factor of 2,” Dr. McCollough says. “The current dose levels are not dangerous, but if we can use less, we will. I can take two Tylenol for a headache and not worry about it being dangerous. But, if one Tylenol will get rid of my headache, it is prudent medicine to take a lower dose — and that is what we want with radiation.”

In addition, radiologists are keenly aware that radiation doses will vary based on patient size, so children are given a child-size dose instead of the amount an adult would receive.

“What we have done over the past decade is, as a community, launched national and international campaigns to make sure that CT providers understand that they need to right-size the dose and dial down for the little ones,” Dr. McCollough says.

If patients are unsure about getting a CT scan, they should ask their referring physician to explain the reasons it was requested. “If there is a reason and the information from the CT will help guide their medical care, then, by all means, patients should go ahead and have that exam and not worry about some small, theoretical, long-term radiation risk,” Dr. McCollough says.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available online at http://www.mayoclinicproceedings.org.

The post Expert alert: Are CT scans safe? appeared first on Mayo Clinic News Network.

“As smokers quit earlier and stay off cigarettes longer, fewer are eligible for CT screening, which has been proven effective in saving lives,” says Ping Yang, M.D., Ph.D., an epidemiologist at Mayo Clinic Cancer Center. “Patients who do eventually develop lung cancer are diagnosed at a later stage when treatment can no longer result in a cure.”

Dr. Yang says researchers and policymakers need to re-examine screening criteria to identify a greater proportion of patients who develop lung cancer.

MEDIA CONTACT:
Joe Dangor, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu.
https://www.youtube.com/watch?v=KYkERiLwaP4&feature=youtu.be
“The existing screening program will become less effective at reducing lung cancer mortality in the general population, if they continue to use the same criteria,” Dr. Yang says.

The study retrospectively tracked residents of Olmsted County in Minnesota who were older than 20 years from 1984 through 2011 — about 140,000 people. Lung cancer cases were identified using the Rochester Epidemiology Project database and confirmed by pathology definition of the World Health Organization.

Researchers determined the proportion of lung cancer patients who would have met CT scan screening criteria set by the U.S. Preventive Services Task Force. Those criteria, used by doctors and insurance companies, recommend CT screening for asymptomatic adults age 55 to 80 who have smoked at least 30 pack-years (one pack a day for 30 years), and are still smoking or have reduced consumption in the last 15 years.

A total of 1,351 people in the study developed primary lung cancer between 1984 and 2011. Researchers found that the incidence of primary lung cancer fell overall during the study period — but only for men by about one-third. Among women, the incidence of lung cancer rose 8 percent.

According to Dr. Yang, the data with greatest relevance to CT screening is the proportion of lung cancer patients who smoked at least 30 pack-years which declined over the study period. And the proportion of cancer patients who had quit for more than 15 years increased. “While more people have quit for a longer period of time, they are still getting lung cancer,” Dr. Yang says, “and they make up a larger proportion of newly diagnosed lung cancer patients.”

As a result, the proportion of lung cancer patients who would have been eligible for screening fell steadily during the study period — from 57 percent in 1984–1990 to 43 percent in 2005–2011. The proportion of women who would have been eligible under the criteria decreased from 52 percent to 37 percent, and among men from 60 percent to 50 percent.

That trend has important consequences, says Dr. Yang.

First, many more patients will miss out on early detection, when treatment of lung cancer is most successful. “That means more patients are going to be diagnosed at a later stage, because they could not take advantage of early detection,” she says. As a result, more patients will die.

Second, Dr. Yang hopes to see screening criteria adjusted to include smokers who have smoked less than 30 pack-years and those who quit more than 15 years ago. “We don’t want to penalize people who succeeded in smoking cessation,” she says.

Dr. Yang says she is aware of many smokers who are cancer-free but continue to smoke in order to be eligible for CT screening.

Third, CT screening — the only screening technology proven to save lives among patients with lung cancer — will become less and less effective unless screening criteria are revised to include more patients who are likely to develop cancer.

Dr. Yang acknowledges there is a danger in relaxing CT-screening criteria too much, citing concerns about cost, radiation exposure and overtreatment due to false positives that increase patient pressure on physicians to remove tumors even if they do not appear dangerous.

“There are ways to screen at-risk patients while still avoiding false alarms and overtreatment,” says Dr. Yang. “Researchers need to discover biological markers, such as genetic or physiological traits, to help them better identify high-risk patients.” She says screening criteria might also be adjusted to include some smokers who have smoked less than 30 pack-years or quit more than 15 years ago. Dr. Yang says she and her colleagues are preparing papers on these issues to develop proposals for more effective CT screening that will save more lives from lung cancer.

The study was supported by grants from the National Institutes of Health, a grant from the National Institute on Aging, and funding from the Mayo Clinic Foundation.

Co-authors include David Midthun, M.D., Jason Wampfler, B.S., of Mayo Clinic; and Yi Wang, M.D., of Medical University, Whenzhou, China.

About Mayo Clinic Cancer Center
As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. For information on cancer clinical trials, call 1-855-776-0015 (toll-free).

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo clinic or https://newsnetwork.mayoclinic.org.

The post Decline in Smoking Rates May Increase Lung Cancer Mortality Due to Inadequate Screening Guidelines appeared first on Mayo Clinic News Network.

Those wishing to contact Mayo Clinic’s Lung Cancer Screening Program in Rochester, Minn., may call 507-538-0340.

Journalists: A broadcast quality video package and additional b-roll are available in the downloads. To access the script, click here. 

This is a special report produced for the Mayo Clinic 150th Anniversary Collection of Stories. To view other stories and learn about Mayo Clinic's sesquicentennial, please click here.  

The post Seeing Cancer Sooner with CT Lung Scans appeared first on Mayo Clinic News Network.

Finding lung cancer sooner rather than later can obviously make a big difference in the outcome, and using a CT scan to find the cancer may be the best option.  On the next Mayo Clinic Radio, Saturday, November 15 at 9 a.m. CT, our guest is pulmonologist David Midthun, M.D.  We'll find out why lung cancer is so deadly and talk about the importance of diagnosing it early.  We'll also be joined by a patient who had her lung cancer diagnosed with a CT scan.  November is Lung Cancer Awareness Month. Hope you'll join us.

Myth or Fact: One in 10 people newly diagnosed with lung cancer have never smoked.

Follow #MayoClinicRadio and tweet your questions.

To listen to the program on Saturday, click here.

Mayo Clinic Radio is available on iHeart Radio.

Listen to this week’s Medical News Headlines: News Segment November 15, 2014 (right click MP3)

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Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

For a look at future program topics, click here.
To find and listen to archived shows, click here.

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