Mass lung cancer screening trial to start this week in Amsterdam

A lung cancer X-ray. Photo:
Smoking is associated with 80% of lung cancer cases. Photo:

The Antoni van Leeuwenhoek hospital in Amsterdam is starting a trial screening for lung cancer in heavy smokers this week, as part of a European wide study.

Some 180,000 people from the Amsterdam region between the ages of 60 and 79 were invited to take part in the trial if they had smoked at least 20 cigarettes a day for 35 years or more. Other trials, in Drachten and Bilthoven, will follow shortly.

The Amsterdam trial is set up to give a CT scan to 2,800 people but some 6,000 have already registered their willingness to participate.

‘Screening helps,’ radiologist and researcher Alexander Schmitz told the AD. ‘Earlier studies into screening in the Netherlands and Belgium have shown that early diagnosis can bring down the chances of dying from lung cancer by 26%.’

Some 10,000 people die from lung cancer in the Netherlands every year. Often patients are diagnosed when the disease is in a late stage. ‘Eight in 10 people die within five years of being diagnosed,’ Schmitz said.

However, the question is whether the people who are selected for the trial are really part of the target group of heavy smokers or if they perhaps exaggerate how much they have smoked. It is also doubtful the group will be representative of society, screening sceptic and family doctor Joost Zaat said.

‘We know that the people who are up for this sort of trial belong to a higher socio-economic class,’ Zaat told the paper. ‘So you don’t really know if you are screening a broad enough group.’ Recent research has shown that lung cancer cases are more often diagnosed in the well-heeled district of Amsterdam Zuid, for instance, Zaat said.

Schmitz maintains that screening saves money on expensive treatment and that a CT scan can also act as a wake up call for inveterate smokers who would be offered help to stop. This, in turn, would lessen their chances of getting heart disease or other smoking related illnesses, he said.

‘Helping people to stop smoking and the screening go hand in hand,’ former lung specialist and anti-tobacco campaigner Wanda de Kanter said. ‘In a few years’ time we will probably have a mobile screening unit going into Amsterdam Noord for a broad screening of heavy smokers there, with on offer of help to quit. But the government must also do more to make sure people don’t start smoking in the first place.’

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