Intended for healthcare professionals

Bmj Usa: Editorial

Computed tomography screening for cancer

BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E207
  1. Stephen J Swensen, professor and chair (
  1. Department of Radiology, Mayo Clinic, Rochester, Minnesota.

    Where are we going?

    From BMJ USA 2003;April:186

    Whole body computed tomography (CT) screening is the focus of a major advertising campaign in the United States. Enticing testimonials on billboards and radio spots urge the public to use this technology, implying that there is much to gain and little to lose. How should primary care physicians advise their patients?

    In one sense, CT screening does have much to offer. As part of a National Institutes of Health study, our center has used CT to screen for lung cancer for the past four years and has identified 56 lung cancers. Fully 62% of the non-small cell cancers were stage IA.1 In the absence of screening, only 15%-20% of lung cancers present at stage IA. Five-year survival for stage I lung cancers, which is approximately 60%-70%, is higher than that for cancers diagnosed at more advanced stages. There is little doubt that CT is more sensitive than chest x ray in detecting small, early-stage lung cancers. Indeed, we found two cancers measuring only 3 mm in diameter.28

    Recognizing that we …

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