The story reports that these scans typically cost $300-400 and are not generally covered by insurance. The story would have been better if it had clearly pointed out that the potentially huge cost of such a screening program, because hundreds of smokers had to be scanned to extend one life in this trial and follow-up tests and treatments cost much more than the initial scan. Nonetheless, we’ll give it the benefit of the doubt on this criterion. The New York Times never specified the scans’ costs. This story does a better job than some others in how it portrays the potential benefits of CT screening for lung cancer. The headline and lead report that deaths were reduced somewhat. The third paragraph of the story notes that among the 53,000 participants there were 20 percent fewer deaths among those offered CT scans compared to those offered chest x-rays, but that the “actual number of deaths averted was fairly modest” (354 in the CT group vs. 442 in the x-ray group). This way of presenting the results helps readers put the results in perspective. The story also notes that the National Cancer Institute said “it’s not clear that all smokers should get the scans.” However, the story could have made it more clear that the reduction in lung cancer death rates was seen after five years of folllow-up, which leaves open the question about whether that difference will persist over a longer time frame. It would have been helpful for this story to tell readers that 300 smokers had to be screened in this trial in order to extend the life of one of them. The story points out that such scans can produce false positive results, lead to further tests and treatments that don’t always benefit patients and have their own risks, and that CT scans expose people to radiation that may raise the risk of other types of cancer. It explains that the NCI is “still compiling the rates of false alarms and other risks” but estimates could have been drawn from past research. The story explains that 53,000 current or former smokers were given either CT scans or chest x-rays and that researchers tracked the number who died of lung cancer. However, readers may be confused by a reference to “the eight-year study period.” While it has been eight years since the trial began, the participants were followed for up to five years. Also, the story leads with a vague statement that this trial provides “the first evidence that a screening test may help fight the nation’s top cancer killer.” It would have been better for the story to be clear that this trial provides evidence about a difference in lung cancer death rates. The story could have done a better job of explaining that the randomization and other features of this trial set it above any other investigation of this topic. The story clearly states that this trial only involved people who are or were “very heavy smokers” and that it is not clear that the results are applicable to other smokers. There is no independent source quoted. (Please note: later versions of AP stories carried independent perspectives but we reviewed the first version we found.) This story highlights advice that quitting is the best way for smokers to avoid lung cancer. While this story does call the CT scans used in this trial “special” and different from conventional CT scans, it does not make clear that the trial applied rigorous standards to the equipment, operators and radiologists that may not be followed by other providers who offer CT scans to smokers. The story squeaks by this criterion. It mentions earlier trials that left key questions unresolved, but it does not clearly tell readers what was different about this trial. The only direct quote in the story is from a news release issued by the National Cancer Institute. (http://www.cancer.gov/newscenter/pressreleases/NLSTresultsRelease) It is not clear what other sources may have been consulted.
Special CT scans cut lung cancer deaths in major study, but questions remain about screening