Some of the latest developments in the treatment and screening for lung cancer were shared at a special dinner for physicians last month.The Brown Darrell Clinic hosted more than 30 physicians as part of ‘Docs for Dinner’.The clinic, which currently has the most powerful CT scanner on the Island, told doctors at the September 21 event it was considering offering lung cancer screening in concert with Massachusetts’ Lahey Clinic.Body & Soul reported in July on the excitement at the Smith’s clinic following an American study that showed CT scanning could improve life expectancy in lung cancer patients by as much as 20 percent. The downside to that news was that scanning in this way gave an extremely high number of false positives 96 percent according to the study.Lung cancer is one of the biggest killers worldwide. It accounts for most of the cancer deaths in Bermuda.Brady McKee, assistant professor of radiology at Tufts University School of Medicine and a radiologist at the Lahey Clinic in Burlington, Massachusetts, was a guest speaker at Docs for Dinner along with his wife, Andrea.Dr McKee presented low-dose CT scanning as a good and viable option for lung cancer screening in heavy smokers.But he also noted that most lung cancer in the US today is in former smokers (50 percent) and people who have never smoked (15 percent).Addressing the concern raised in the study at the large number of false positives, Dr McKee said that chance of over-diagnosis falls significantly once the Fleischner Criteria are applied to the CT scan results.The Fleischner Criteria is a set of guidelines agreed on by the Fleischner Society, an international, multidisciplinary medical society for thoracic radiology, dedicated to the diagnosis and treatment of diseases of the chest.The Society recognised that with every advancement in CT scanning the machines were becoming more sensitive and detecting more tumours.As a result it agreed, in 2005, on guidelines to determine which situations required follow-up scans. In its position paper on the topic, the Society admitted that it was too costly to do follow-up scans for every nodule detected, and expressed concern at the radiation exposure too many scans could pose for patients.The Fleischner Criteria make it very clear which cases should be followed up with another scan. The criteria are based on the size of the tumour and the patient’s risk of lung cancer.The patient’s smoking history plays a large part in determining high or low risk for lung cancer.Using the Fleischner Criteria, nodules four millimetres or smaller would not require any follow-up for those patients at low risk for lung cancer. High-risk patients with a nodule this side should have a follow-up scan in a year. If the size has not increased at that time, no further follow-ups should be done.Dr Brady said in his experience treating these tumours early has greatly improved survival rates of lung cancer patients.His wife spoke on improvements in treatment. Body & Soul will feature details of her talk later this month.