"Are lung cancer httpshealth.nytimes.comhealthguidesdiseasecanceroverview.htmlinlinenytclassifier scans really ready for prime time News that annual CT lung scans can reduce the risk of lung cancer death https_rscpsqScansCutDeathsByLungCancerAmongSmokersstcse among former and current heavy smokers was celebrated by national heath officials this month. A major government study found the screening scans saved the life of one person for every  current or former smokers who were scanned. But now cancer and screening experts are worried that the limited findings will be used by private screening centers to promote the test to a broader group than was studied. That in turn could lead to thousands of unnecessary lung scans causing excess radiation exposure and unnecessary biopsies and surgery. Dr. Otis W. Brawley chief medical officer of the American Cancer Society httpstopics.nytimes.comtopreferencetimestopicsorganizationsaamerican_cancer_societyindex.htmlinlinenytorg said he was stunned to hear a radio advertisement for an Atlanta screening center cite the study just a few days after the government had announced the results. The wording of the ad seemed to be aimed at a broad group ranging from heavy smokers to women who had never smoked Dr. Brawley said. We really need to weigh the harms associated with screening he said. The scientific community still needs to digest this. To take a trial that involves people at high risk for lung cancer and to extrapolate it and say its good for people with intermediate or low risk is not appropriate. The study called the National Lung Screening Trial https focused on a specific highrisk group  current and former heavy smokers aged  to  who had smoked for at least  packyears. That means someone who smoked one pack a day for  years two packs a day for  years or three packs a day for at least  years would qualify for the study. Former smokers who had accumulated  packyears were included only if they had stopped smoking httpshealth.nytimes.comhealthguidesspecialtopicsmokingandsmokelesstobaccooverview.htmlinlinenytclassifier within the previous  years. The smokers and former smokers were given either annual CT lung scans or chest Xrays. Compared with conventional Xrays the CT or computed tomography scans create a detailed threedimensional image of the lungs. The study was stopped when it was found that the scanning group had a  percent lower risk of dying from lung cancer than those being screened with Xrays. But the early results also showed a downside of scanning one of every four lung scans showed an abnormality which often led to additional worry radiation exposure from followup scans and sometimes lung biopsies and even risky surgery. But because the study was stopped early a full analysis of the harms caused by screening scans is still months away. Reading the scans is tricky because harmless nodules httpshealth.nytimes.comhealthguidessymptomsnodulesoverview.htmlinlinenytclassifier can be misinterpreted as suspect lesions. In the study even experienced radiologists at major cancer centers had a high rate of false positives suggesting that the rate would be even higher in the real world. There is a learning curve to reading spiral CTs Dr. Brawley said. Im concerned that some radiologists might be early in that learning curve and some patients may be harmed because of it. While the study found a benefit to scanning a specific group of highrisk smokers that doesnt mean other groups will get the same benefit says Dr. Peter B. Bach a pulmonologist at Memorial SloanKettering Cancer Center httpstopics.nytimes.comtopreferencetimestopicsorganizationsmmemorial_sloankettering_cancer_centerindex.htmlinlinenytorg in New York. In lowerrisk groups for instance its likely that thousands of people would need to be exposed to the risks of screening before a single life was saved. And its possible that many of those scanned unnecessarily could be seriously harmed. The aggregate harms to all the peoples lives who are not saved have to be taken into account Dr. Bach said. Even in these highly controlled settings about  percent of the people had surgery or a part of their lung removed for something they thought was cancer and it wasnt. Lowdose CT scans expose patients to about the same radiation levels as mammograms httpshealth.nytimes.comhealthguidestestmammographyoverview.htmlinlinenytclassifier. For now most consumers who want a scan will have to pay for it themselves although it is expected that insurance companies eventually will approve scanning for those in highrisk groups. Medicare httpstopics.nytimes.comtopnewshealthdiseasesconditionsandhealthtopicsmedicareindex.htmlinlinenytclassifier officials have indicated that they will soon reconsider paying for the screening tests. The government has estimated the cost at about  a scan but some centers may charge  or more. The day the government announced the study results Westside Medical Imaging of Beverly Hills Calif. issued a press release saying that the study should once and for all settle the controversy about whether CT lung scans save lives. In the release Dr. Norman E. Lepor said the scans were an indispensable part of annual exams for patients who have smoked for  years. In an interview Dr. Lepor said that he only offers lung scans to those at high risk and that he turns people away who are at low risk but want the scan anyway because they just want to know. Dr. Lepor said it would be imprudent not to incorporate the latest study data into his practice right away. There are people who with good conscience and their take of the data say its not ready for prime time and there are people who look at the same data and they come to other conclusions Dr. Lepor said. This is not the first study that has supported screening. We know from our own anecdotes that we have saved a lot of lives. Dr. Lepor said that he had just met a woman who had smoked for  years and was concerned about her risk. Shes the poster person for this test he said. Dr. Brawley said hes worried that the few early press releases and radio advertisements are just the beginning of widespread promotion of screening lung scans. It was sort of ominous to be working Sunday evening in my home office and this thing comes on the radio he said. A lot of people run out when there is a new announcement and get the new test. Were very frightened some people are going to be harmed because of this."