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In Brief
CT Scans for Lung Cancer Yield High False-Positive Rate, Study Finds
A new study has found that helical chest computed tomographic (CT) scanning may help detect early-stage lung cancers—but with a high false-positive rate and a questionable effect on mortality.
Stephen J. Swensen, M.D., and colleagues from the Mayo Clinic in Rochester, Minn., followed a cohort of 1,520 current or former smokers age 50 or older who underwent a baseline CT scan and four subsequent annual examinations. A total of 3,356 nodules were identified in 1,118 (74%) participants. The false-positive rate ranged from 92% to 96%, and 69% of patients in the trial had at least one false-positive finding.
During the 5 years of the study, 68 primary lung cancers were found in 66 participants, 31 of which were found on the first CT examination and 34 of which were found on follow-up examinations. (Three cases were interval cancers.)
"CT screening for lung cancer offers the possibility of reducing mortality from lung cancer," the authors wrote. "Our preliminary results do not support this possibility and may raise concerns that false-positive results and overdiagnosis could actually result in more harm than good."
The study was published in the April issue of Radiology.
Women With HIV May Need Cervical Cancer Screening Only Every 3 Years
A new study has found that women with human immunodeficiency virus (HIV) who have normal cervical cancer screening results and test negative for human papillomavirus (HPV) may be able to be screened on the same 3-year schedule that is recommended for HIV-negative women.
In the United States, current cervical cancer screening recommendations advise that women age 30 and older who have three consecutive normal cytology results may be screened every 3 years. However, cervical cancer screening guidelines for HIV-positive women have not been updated since 1995 and do not consider HPV status.
To determine whether a single HPV test can be used to determine the appropriate cervical cancer screening interval for HIV-positive women, researchers studied the incidence of cervical squamous intraepithelial lesions (SILs) among 855 HIV-positive and 343 HIV-negative women in the Women's Interagency HIV Study. Their results were published in the March 23/30 issue of the Journal of the American Medical Association.
After 2 years, there was no difference in the incidence of SIL between the two groups among women who were HPV-negative. The researchers conclude that similar cervical cancer screening guidelines may apply to both groups. However, they recommend that this strategy be evaluated in a clinical trial.
Adding Bevacizumab to Chemotherapy Prolongs Lung Cancer Survival, Trial Finds
Patients with non–small-cell lung cancer (NSCLC) treated with bevacizumab (Avastin) in combination with standard chemotherapy lived longer than patients treated with chemotherapy alone, according to the preliminary results of a large, randomized clinical trial.
The trial, E4599, which was conducted by a network of researchers led by the Eastern Cooperative Oncology Group, enrolled 878 patients with advanced NSCLC who had not previously received systemic chemotherapy. Patients received either standard treatment with paclitaxel and carboplatin or standard treatment followed by bevacizumab alone. Bevacizumab is a monoclonal antibody that was designed to inhibit vascular endothelial growth factor (VEGF), a protein involved in angiogenesis.
Patients who received the standard treatment plus bevacizumab survived longer (12.5 months) than patients who received only the standard treatment (10.2 months). The trial's data safety monitoring committee recommended that these results, which were from an interim analysis, be made public because the trial had met its primary endpoint of improving overall survival. Detailed results from the study will be presented at the American Society of Clinical Oncology annual meeting in May.
A press release from the National Cancer Institute is available at http://www.cancer.gov/newscenter/pressreleases/AvastinLung.
Group Recommends Earlier Colorectal Cancer Screening for African Americans
The American College of Gastroenterology has recommended that physicians begin screening African Americans for colorectal cancer at age 45 rather than at age 50, the general recommendation made by several groups.
In the publication of the recommendation, which appears in the March issue of the American Journal of Gastroenterology, the authors point out that African Americans have the highest incidence of colorectal cancer of any racial or ethnic group. In addition, they note that the mean age of presentation among African Americans is lower than in whites.
The group further recommends that colonoscopy be used as the screening method of choice because some studies have found an increased number of polyps and cancers in the proximal colon, which cannot be seen with flexible sigmoidoscopy.
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