PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Evidence review examines both benefits and harms for lung cancer screening

Evidence review examines both benefits and harms for lung cancer screening
2021-03-09
(Press-News.org) CHAPEL HILL, NC -- A comprehensive review by University of North Carolina researchers and colleagues of hundreds of publications, incorporating more than two dozen articles on prevention screening for lung cancer with low-dose spiral computed tomography (LDCT), shows there are both benefits and harms from screening. The review is published in JAMA on March 9, 2021.

The results of the decadelong National Lung Screening Trial (NLST) showed that LDCT could detect lung cancer better than conventional X-rays in current or previous heavy smokers. Based on those results, the United States Preventive Services Task Force (USPSTF) initially recommended low-dose CT screening for people ages 55 to 80 with a 30 pack-year smoking history. Subsequently, other screening trial results have been published, including a European trial called NELSON, the next-largest study to the NLST. NELSON also found a reduction in deaths due to lung cancer because of screening.

It has been nearly a decade since the initial recommendations were formulated, so the USPSTF initiated an updated review of the evidence. UNC scientists and their collaborators evaluated and synthesized data from the seven trials to arrive at a comprehensive, current assessment of harms and benefits of screening.

New recommendations, based on this evidence review, broaden the criteria for screening eligibility by lowering the screening age from 55 to 50 and reducing the pack-year requirement from 30 to 20 pack-years. There were several reasons for this change in eligibility according to the reviewers; one was to promote health equity, in part because African Americans have higher lung cancer risk even with lower levels of smoking exposure.

"Two large studies have now confirmed that screening can lower the chance of dying of lung cancer in high-risk people. However, people considering screening should know that a relatively small number of people who are screened benefit, and that screening can also lead to real harms," said Daniel Reuland, MD, MPH, one of the review authors, a member of the UNC Lineberger Comprehensive Cancer Center, and a professor in the division of General Medicine and Clinical Epidemiology at UNC School of Medicine.

In screening with CT scans, doctors are looking for lung spots or nodules that might represent early lung cancer. Harms from screening can come from the fact that the large majority of the nodules found on screening are not cancer. These findings are known as false positives, and patients with these results usually require additional scans to see if the spots are growing over time. In some cases, these false positives lead to unnecessary surgery and procedures. Throughout the process, patients may experience the mental distress of a possible cancer diagnosis.

"Applying screening tests to a population without symptoms of disease can certainly benefit some people but also has the potential for some harms," said lead author Daniel Jonas, MD, MPH, who conducted most of this research while he was a professor at the UNC School of Medicine and now is director of the division of general internal medicine at Ohio State University. "In the case of lung cancer screening, we now have more certainty that some individuals will benefit, with some lung cancer deaths prevented, and we also know others will be harmed. The USPSTF has weighed the overall benefits and harms, and on balance, based on our review and from modeling studies, has determined that screening with LDCT has an overall net benefit for high-risk people ages 50 to 80."

Reuland and Jonas note that, encouragingly, lung cancer rates are declining, reflecting changing smoking patterns in recent decades. Therefore, the population eligible for screening is also projected to decline. At this point, however, they don't foresee these trends changing screening recommendations during the next decade or so.

"Different trials have used different screening approaches, and we still do not know how often screening should be done or which approach to categorizing lesions is best for reducing the harms, costs and burdens of screening while retaining the benefits," said Reuland, who is also a research fellow at UNC's Cecil G. Sheps Center for Health Services Research. "I would prioritize this as an important area of future research, as it could likely be addressed by implementing less expensive studies or using approaches other than those used in the large trials we just reviewed."

INFORMATION:

In addition to Reuland and Jonas, the other authors are Shivani M. Reddy, MD, MSc, RTI International-UNC Evidence-based Practice Center; Max Nagle, MD, MPH, University of Michigan; Stephen D. Clark, MD, MPH, Virginia Commonwealth University; Chineme Enyioha, MD, MPH, UNC School of Medicine; Teri L. Malo, PhD, MPH, and Alison T. Brenner, PhD, MPH, UNC Lineberger; Rachel Palmieri Weber, PhD, Charli Armstrong, BA, Manny Coker-Schwimmer, MPH, Jennifer Cook Middleton, PhD, and Christiane Voisin, MSLS, RTI International-UNC Evidence-based Practice Center and UNC Cecil G. Sheps Center for Health Services Research; Russell P. Harris, MD, MPH, UNC School of Medicine and the UNC Cecil G. Sheps Center for Health Services Research.


[Attachments] See images for this press release:
Evidence review examines both benefits and harms for lung cancer screening

ELSE PRESS RELEASES FROM THIS DATE:

Strategic air purifier placement reduces virus spread within music classrooms

2021-03-09
WASHINGTON, March 9, 2021 -- The University of Minnesota School of Music was concerned about one-on-one teaching during the COVID-19 pandemic and wondered if it should supplement its ventilation system with portable HEPA air purifiers. So, school officials reached out to Suo Yang, a professor within the College of Science and Engineering, and his team to figure it out. In Physics of Fluids, from AIP Publishing, Yang and the researchers describe their work to predict how virus particles spread within a music classroom. "The airborne transmission of COVID-19 through ...

Younger Tyrannosaurus Rex bites were less ferocious than their adult counterparts

Younger Tyrannosaurus Rex bites were less ferocious than their adult counterparts
2021-03-09
By closely examining the jaw mechanics of juvenile and adult tyrannosaurids, some of the fiercest dinosaurs to inhabit earth, scientists led by the University of Bristol have uncovered differences in how they bit into their prey. They found that younger tyrannosaurs were incapable of delivering the bone-crunching bite that is often synonymous with the Tyrannosaurus Rex and that adult specimens were far better equipped for tearing out chunks of flesh and bone with their massive, deeply set jaws. The team also found that tension from the insertion of the lower pterygoid muscle is linked to decreasing stresses near the front of the typical tyrannosaur jaw, where the animals may have applied their highest impact bite ...

Irradiating COVID-19 cough droplets with UV-C lamps

Irradiating COVID-19 cough droplets with UV-C lamps
2021-03-09
WASHINGTON, March 9, 2021 -- One of the primary ways the COVID-19 virus is transmitted is via airborne diffusion of saliva microdroplets, so it is paramount to find methods to kill the virus in airborne microdroplets. The extreme confusion that abounded at the beginning of the pandemic about safe social distances, mask wearing, and social behavior inspired Marche Polytechnic University researchers, who happen to be intrigued by saliva droplet diffusion, to search for answers and ways to help. In Physics of Fluids, from AIP Publishing, Valerio D'Alessandro and colleagues describe using a supercomputer to do numerical modeling ...

Study looks at effect of COVID-19 policies on vehicle crashes, traffic volume in Ohio

2021-03-09
(COLUMBUS, Ohio) - To minimize transmission of COVID-19, in spring 2020, most U.S. states passed policies promoting social distancing through stay-at-home orders prohibiting non-essential travel. Vehicle-miles traveled in the U.S. decreased by 41% in April 2020 compared to 2019. A new study led by researchers at the Center for Injury Research and Policy at Nationwide Children's Hospital estimated associations between COVID-19-related social-distancing policies, traffic volume, and motor vehicle crash-related outcomes in Ohio. The study, published today in JAMA, found the number of individuals involved in a motor vehicle crash, sustaining injury, sustaining ...

Microwave-assisted recording technology promises high-density hard disk performance

Microwave-assisted recording technology promises high-density hard disk performance
2021-03-09
WASHINGTON, March 9, 2021 -- Researchers at Toshiba Corporation in Japan have studied the operation of a small device fabricated in the write gap of a hard disk drive's write head to extend its recording density. The device, developed by HWY Technologies, is based on a design concept known as microwave-assisted magnetic recording, or MAMR. This technology, reported in the Journal of Applied Physics, by AIP Publishing, uses a microwave field generator known as a spin-torque oscillator. The spin-torque oscillator emits a microwave field causing the magnetic particles of the recording medium to wobble the way a spinning top does. This makes them much easier to flip over when the write head applies a recording magnetic ...

A trio that could spell trouble: Many with dementia take risky combinations of medicines

2021-03-09
People over 65 shouldn't take three or more medicines that act on their brain and nervous system, experts strongly warn, because the drugs can interact and raise the risk of everything from falls to overdoses to memory issues. But a new study finds that 1 in 7 people with dementia who live outside nursing homes are taking at least three of these drugs. Even if they received the drugs to calm some of dementia's more troubling behavioral issues, the researchers say, taking them in combination could accelerate their loss of memory and thinking ability, and raise their chance of ...

90-day dapivirine ring for women's HIV prevention passes its first test in Phase I study

2021-03-09
PITTSBURGH, 9 March 2021 - If approved, the monthly dapivirine vaginal ring would be the first biomedical HIV prevention method designed specifically for cisgender women, as well as the first long-acting method. Looking to the future, researchers from the National Institutes of Health-funded END ...

Characterizing different cell types in the upper gastrointestinal tract

Characterizing different cell types in the upper gastrointestinal tract
2021-03-09
Researchers from the group of Hans Clevers identified and characterized rare cell types in the upper gastrointestinal tract. Using single cell RNA sequencing, they studied the cellular composition of the esophagus, stomach and upper part of the small intestine. They provide detailed gene expression analyses for all epithelial cells in these organs. Furthermore, they identified a rare cell type that is most likely responsible for the secretion of high volumes of water in humans. This cell type provides a link to gastrointestinal defects in patients with cystic fibrosis. The paper was published in Cell Reports on the 9th ...

Social distancing policies, changes in traffic volume, accidents, injuries

2021-03-09
What The Study Did: Researchers compared traffic volume and motor vehicle crash injuries before, during and after COVID-19-related state-of-emergency and stay-at-home orders in Ohio from January to July last year with the same period in 2019. Authors: Motao Zhu, Ph.D., of the Abigail Wexner Research Institute at Nationwide Children's Hospital in Columbus, Ohio, is the corresponding author. To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ (doi:10.1001/jama.2020.25770) Editor's Note: The article includes conflicts of interest and funding/support disclosures. Please see the article ...

Adhesion, contractility enable metastatic cells to go against the grain

2021-03-09
Bioengineers at the University of California San Diego and San Diego State University have discovered a key feature that allows cancer cells to break from typical cell behavior and migrate away from the stiffer tissue in a tumor, shedding light on the process of metastasis and offering possible new targets for cancer therapies. It has been well documented that cells typically migrate away from softer tissue to stiffer regions within the extracellular matrix-- a process called durotaxis. Metastatic cancer cells are the rare exception to this rule, moving away from the stiffer tumor tissue to softer tissue, and spreading ...

LAST 30 PRESS RELEASES:

Signs identified that precede sudden arrhythmic death syndrome in young people

Discovery of bacteria's defence against viruses becomes a piece of the puzzle against resistance

Pre-eclampsia is associated with earlier onset and higher incidence of cardiovascular risk factors

Warwick astronomers discover doomed pair of spiralling stars on our cosmic doorstep

Soil conditions significantly increase rainfall in world’s megastorm hotspots

NK cells complexed with bispecific antibody yield high response rates in patients with lymphoma

Planetary health diet and mediterranean diet associated with similar survival and sustainability benefits

Singapore launches national standard to validate antimicrobial disinfectant products

Molecular stool test could improve detection of tuberculosis in adults with HIV

Suspected fibrocartilaginous embolus in Asian small-clawed otter (Aonyx cinereus)

Enhancing heat transfer using the turbulent flow of viscoelastic fluids

Exercise as an anti-ageing intervention to avoid detrimental impact of mental fatigue

UMass Amherst Nursing Professor Emerita honored as ‘Living Legend’

New guidelines aim to improve cystic fibrosis screening

Picky eaters by day, buffet by night: Butterfly, moth diets sync to plant aromas

Pennington Biomedical’s Dr. Leanne Redman honored with the E. V. McCollum Award from the American Society for Nutrition

CCNY physicists uncover electronic interactions mediated via spin waves

Researchers’ 3D-printing formula may transform future of foam

Nurture more important than nature for robotic hand

Drug-delivering aptamers target leukemia stem cells for one-two knockout punch

New study finds that over 95% of sponsored influencer posts on Twitter were not disclosed

New sea grant report helps great lakes fish farmers navigate aquaculture regulations

Strain “trick” improves perovskite solar cells’ efficiency

How GPS helps older drivers stay on the roads

Estrogen and progesterone stimulate the body to make opioids

Dancing with the cells – how acoustically levitating a diamond led to a breakthrough in biotech automation

Machine learning helps construct an evolutionary timeline of bacteria

Cellular regulator of mRNA vaccine revealed... offering new therapeutic options

Animal behavioral diversity at risk in the face of declining biodiversity

Finding their way: GPS ignites independence in older adult drivers

[Press-News.org] Evidence review examines both benefits and harms for lung cancer screening