Day: 11/05/2010

Annual Low-Dose CT Screening Better Than Chest X-Ray for Reducing Lung Cancer Mortality

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Annual low-dose computed tomography cuts more lung cancer deaths than chest radiography among high-risk patients, according to early, as-yet unpublished findings from the National Lung Screening Trial released by the National Cancer Institute.

More than 53,000 current or former heavy smokers (aged 55 to 74) without signs or symptoms of lung cancer were randomized to undergo low-dose CT or chest radiography at baseline and then annually for 2 years. During follow-up, lung cancer mortality was 20% lower with CT than with radiography. (Based on this finding, the trial’s data and safety monitoring board recommended stopping the study.)

The NCI’s Dr. Christine Berg said: “This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial. The fact that low-dose helical CT provides a decided benefit is a result that will have implications for the screening and management of lung cancer for many years to come.”

Endocrine Society Releases Guidelines for Care of Patients After Bariatric Surgery

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The Endocrine Society has released guidelines for the nutritional and endocrine care of patients after bariatric surgery.

The recommendations, published in the Journal of Clinical Endocrinology & Metabolism, stress the importance of a multidisciplinary team that involves a primary care physician and an endocrinologist or gastroenterologist.

Among the recommendations:

  • Treatment of weight regain should include dietary counseling, physical activity (at least 150 minutes weekly), behavior modification, and drug therapy. (Roughly 20 to 25% of lost weight will be regained over 10 years).
  • Patients should get 60 to 120 g of protein daily, as well as vitamin and mineral supplementation.
  • For bone health, patients who’ve undergone malabsorptive procedures (e.g., Roux-en-Y bypass) should have measurements of vitamin D, calcium, phosphorus, parathyroid hormone, and alkaline phosphatase levels every 6 months and bone density checked yearly until stable.
  • To assess nutritional deficiencies after malabsorptive procedures, ferritin, vitamin B12, folate, vitamin D, and calcium levels should be assessed every 6 months for the first 2 years, and then annually thereafter.