Beyond the pink: Are we there yet?

October, National Breast Cancer Awareness Month, typically brings a bevy of pink ribbons, t-shirts and more. This year, the color pink seems to have exploded. It’s a marketing success story, but will it translate into actions that make a difference?

That question remains unanswered. As I re-read this week’s news, I noticed a corollary in some of the top stories of the week. Two weeks ago, I reviewed a Journal of the American Medical Association editorial that pointed out the incremental diagnostic value inherent in CT lung cancer screening. Imaging data, the editorialists argued, can be leveraged to enable physicians to screen patients for cardiovascular disease, chronic obstructive pulmonary disease and osteoporosis. It is, to use a tired phrase, a value proposition.

Not so fast, responded Health Imaging reader Carter Newton, MD. In an eloquent response, Newton detailed the clinical, practical and economic fallout that can accompany screening programs.

I’ve heard that some screening proponents were less than pleased with the response. However, dialogue and debate, like awareness, represents a positive interim step.

And the debate rages on. Non-contrast cardiac CT scans of the heart can provide extra diagnostic information beyond calcium scoring, according to a review published in the September issue of Journal of Cardiovascular Computed Tomography by Paul Madaj, MD, and Matthew J. Budoff, MD, of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.

Meanwhile, the Fleischner Society has taken an important step in helping physicians handle the conundrum of managing subsolid lesions identified during lung cancer CT screening. The society’s goal is to provide more specific guidance to help address this diagnostic conundrum.

Finally, U.K. researchers have launched a study to determine who faces a higher risk for lung and colon cancers. The researchers will analyze blood samples and genetic data to identify markers that could predict the diseases.

Similar studies, which could ultimately target screening efforts, are taking place at research institutions around the globe. A healthy handful of this work, including a study that shows blood hormone levels can predict breast cancer up to 20 years in advance, is being presented at the annual meeting of the American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research. Stay tuned as more data are shared.

These data will raise awareness and inform dialogue and debate, but that doesn’t close the case.

The end goal of awareness is action, and the end goal of dialogue and debate is consensus. Are we there yet? Not quite, but I’m hopeful that we’ll reach the destination.    

Lisa Fratt, editor