Lung cancer screening of all current and former smokers with low-dose CT scanning would result in preventing 12,000 deaths in the United States each year. A study in Cancer reported that, compared with chest x-ray, CT screening would reduce lung cancer mortality by 20%. The total number of potentially avoidable deaths could even be greater. The patients in the study were 55 to 74 years of age and smoked at least one pack a day for 30 years. Even though these patients are at risk for cancer, screening is generally performed by chest x-ray which misses 20% of tumors.
Subarachnoid hemorrhage (SAH) cannot be ruled out by CT scan or history with physical examination alone, according to a recent study published in Annals of Emergency Medicine. A lumbar puncture with examination of the cerebrospinal fluid is the only way to rule subarachnoid bleeding. Previous studies have reported that a clinical decision rule can rule out SAH with 100% sensitivity. Other studies have reported that a CT scan of the brain within 6 hours can rule SAH out with 100% accuracy. This study says otherwise. The researchers retrospectively looked at cases of SAH in patients with normal neurological exams and also looked at the accuracy of the clinical rule test and the CT imaging test. Sixty two percent (62%) of these patients had cerebral aneurysms and were presenting with signs of small early sentinel bleeds. This important proper diagnosis allows treatment time prior to catastrophic rupture.