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X-ray, CT scan, sputum cytology
Previous studies for screening of high-risk patients for lung cancer, have not produced successful results in terms of increased survival, hence routine screening for lung cancer is generally recommended. Some experts feel that the resources to be spent for screening lung cancer should be diverted to efforts in preventing lung cancer. Regardless of these negative results, some investigators believe that screening of lung cancer in high-risk population, like heavy smokers or those who had occupational exposure to high-risk materials, will help to detect the disease early. There has been some recent studies with screening CT scans, that had shown benefit if used in high-risk population. The recent addition of low dose helical CT scan with its superior performance has renewed interest in lung cancer screening and there is a growing trend among physicians to recommend superior imaging techniques like helical CT scan for screening high risk individuals. Also it is to be mentioned that the threshold of suspicion for lung cancer on high-risk patients should be low, and anyone presenting
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with any symptom or sign suggestive of a possibility of lung cancer should undergo complete evaluation with chest X-ray or CT scan. Lack of guidelines in lung cancer screening should not lead to denial of diagnostic tests needed in this situation.
Chemoprevention of lung cancer
Patients who have been cured of lung cancer may be at a higher risk of developing a second lung cancer. There is about 1 percent to 3 percent chance per year of developing a second lung cancer for the first five years of successful treatment of first lung cancer. A drug by name 13-cis retinoic acid (isotretinoin) was proposed for use in this situation to decrease the risk of developing a second lung cancer. This drug is shown to be successful in preventing the occurrence second cancer in successfully treated head and neck cancers. Studies are ongoing in this regard to determine the efficiency of this drug for previously resected lung cancer patients. The early results from this study are not encouraging. Hence this treatment is not recommended at this time.
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