Study: Routine Chest X-Rays Don’t Cut Lung Cancer Death

Annual chest X-rays may not prevent lung cancer deaths, according to new findings published in JAMA and presented today at the annual meeting of the American College of Chest Physicians.

The study was part of the larger Prostate, Lung and Colorectal Cancer Screening Trial, which included more than 150,000 participants ages 55 to 74.  Researchers found that smokers and non-smokers who were given annual chest x-rays for as long as four years were just as likely to die from lung cancer as those who were not screened.

During the 13-year period of the study, 1,696 patients who underwent annual chest x-rays developed lung cancer, compared to 1,620 patients that developed lung cancer but did not get chest x-rays.

There were about 1,200 lung cancer deaths in participants who got X-rays and in those who did not undergo screening.

An estimated 220,000 people nationwide have lung cancer, and more than half that number will die from the disease, according to the American Cancer Society. It is considered the leading cause of cancer death in the U.S.  

A chest X-ray is one of a few screening options for lung cancer and, for years, many medical experts recommended X-ray screenings for both smokers and non-smokers.

In 2004, the U.S. Preventive Services Task Force concluded  that there was no evidence to support any type of routine lung cancer screening in people without symptoms of the disease.

The latest findings come at the heels of another large trial, called the National Lung Screening Trial, which showed the computed tomography (CT) scans were slightly better at preventing lung cancer death compared to X-rays.

“All prior studies assessing chest X-rays as a screening maneuver for lung cancer were negative, but some folks had remained unconvinced,” said Dr. Robert Mayer, vice chairman for academic affairs at the Dana-Farber Cancer Institute. “Hopefully, this study will end the discussion.”

This study begs research into whether routine CT scans, another  screening method, can prevent death in those who may show symptoms, compared to not getting screened, Dr. Harold Sox, a professor in the department of medicine at the Dartmouth Institute, wrote in an accompanying editorial.