Making a breakthrough better: Improving low dose CT scans



BACKGROUND:   Lung cancer is the second most common cancer in both men and women, accounting for about 14% of all new cancers.  The American Cancer Society estimates that in the United States in 2013 there will be over 200,000 new cases of lung cancer.  There will also be an estimated 159,480 deaths from lung cancer, about 27%.  Lung cancer is the leading cause of cancer death among men and women.  It mainly occurs in older people.  About two out of three people diagnosed with lung cancer are 65 years or older.  The average age at the time of diagnosis is about 71.  The chance of a man developing lung cancer is one in 13; for a woman the risk is about one in 16.  (Source:

RISKS:  Patients at high risk for developing lung cancer are those who are between the ages 55 and 74, are current smokers or quit within the last 15 years, or smoked for 30 or more pack years (pack years means the average number of packs smoked per day multiplied by the number of years a person has smoked.  (Source:

LOW-DOSE CT SCAN:  Early detection is proven to be a successful strategy for fighting many forms of cancer.  More than 75 percent of people with lung cancer have incurable, locally advanced, or metastatic disease at the time of diagnosis, with a five-year survival rate less than 5 percent.  Detecting lung cancer at its earliest stage and having it removed surgically can mean that a person can expect a five-year survival rate that is closer to 70 percent.  During a randomized national trial involving more than 53,000 participants who were current or former heavy smokers between the ages of 55 and 74, the low-dose helical computed tomography (CT) found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT. Helical CT uses X-rays to obtain a multiple-image scan of the entire chest during a 7 to 15 second breath-hold.  A standard chest X-ray requires only a sub-second breath-hold but produces a single image of the whole chest in which anatomic structures overlie one another.  It was the first time that clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial was discovered.  (Source:

NEW TECHNOLOGY:  Researchers at Duke developed a new diagnostic test that employs an instrument called “MALDI-TOF MS” to detect proteins in the blood that signal inflammatory diseases and cancers.  By finding a disease-causing protein, doctors can diagnose the disease and develop new ways to block its detrimental effects.  The specific protein, serum amyloid A, was elevated in the blood of lung cancer patients but not in the blood of normal patients.  Serum amyloid A has previously been shown to be elevated in cancers and other diseases, but researchers at Duke were the first to use MALDI-TOF MS to identify this protein and others that may be involved in lung cancer.  Once the proteins are identified, they can be used as biologic markers to diagnose the earliest stage of cancer, possibly before a CT scan can pick up the image of a tumor on the lungs. Based on their findings, researchers plan to develop a blood test that will measure serum amyloid A and other specific proteins that can detect lung cancer in the blood before a tumor is apparent.  (Source: