NEW YORK (Reuters Health) - pneumonia patients who are less than 50 years and who do not smoke do not need chest x-rays to look for lung cancer, suggests a new study of the Canada.
The conclusion is contrary to most of the guidelines for the treatment of pneumonia, who say that patients should have the x-rays to exclude the lung cancer as the cause of the pneumonia.
It is also in the recent research suggesting that scans of chest radiation may increase the risk of certain cancers, including breast cancer.
"If you are more than 50 years of age and a smoker, you need a follow-up chest x-ray,"Dr. Eric Mortensen, who has studied the pneumonia and lung cancer, at the University of Texas Health Science Center at San Antonio, told Reuters Health.""
However, "it is important not be exposing people who do not have a radiation risk (lung cancer), has added" said Mortensen, who was not involved in the present study.
Dr. Sumit Majumdar of the University of Alberta in Edmonton and his colleagues followed on 3 400 patients treated for pneumonia in their city between 2000 and 2002.
Patients have an average age of 58, and approximately one in six were smokers.
During the 3 months after that they have been diagnosed with pneumonia, less than half of the patients received an x-ray to check for lung cancer.
Just over 1% of all patients of pneumonia (36 people) have been diagnosed with cancer of the lung, based on an x-ray in these 3 months - which increased by 2.3% (79) with x-rays given over the next 5 years. None of the patients younger than 40 got cancer of the lung during these 5 years of follow-up.
The researchers calculated that if all patients were given a chest x-ray quickly after the treatment of pneumonia, 1.7 per cent of them have been diagnosed with lung cancer. If Chest Physicians limited x-ray patients 50 and older, that a case of lung cancer would have been missed and near 3 percent of chest x-rays have found cancer in the elderly population.
One might think chest x-rays only should be performed on patients with pneumonia 50 years and more to reduce the number of x-ray on people who are very likely to have lung cancerthe authors write in Archives of Internal Medicine.
They add that the costs of an x-ray in Edmonton are approximately $35, so only Imaging patients older than 50 years cost would be $ 1,250 "by detected lung cancer", versus $2 when all patients with pneumonia radiographs.
The guidelines recommend that patients with pneumonia tested for both because lung cancer may be closely related.
"One of the reasons people get pneumonia is because their lungs, draining are not of correctly... because there is a hidden cancer, and it is as a sewer backup", Majumdar told Reuters Health.
But in reality, the results show that lung cancer is very rarely the cause of pneumonia, said.
Mortensen said that additional radiation given by a single x-ray is not much, but might as well be avoided if possible. In addition, he said, when more people who have probably not lung cancer lung x-rays, "We will find things are not really there," leading to more tests unnecessary or treatment even in people who are not cancer.
"We need to really understand which populations are at risk of lung cancer and those who are those that that we should be aiming (x-ray)," Mortensen concluded. "Is added costs, he added the radiation, and if you have not it, you need it.".
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