Following a study conducted by the IEO (European Institute of Oncology) in a large sample of heavy smokers, Umberto Veronesi announced today (November 25, 2010) that spiral CT can detect lung cancer in the very early stages and, therefore, operable with excellent prospects in terms of prognosis for the patient (http://www.repubblica.it/ salute/medicina/2010/11/25/news/tumori_polmone_tac_spirale_dimezza_mortalit-9501468 /? ref = HRER2-1)
Along with the scientific result, Veronesi has announced its intention to propose that both the NHS to pay for these (rather expensive) early screening campaigns, as is the case for the PAP test (ovarian cancer) and mammograms (breast cancer).
Beyond the affordability of such an interesting initiative, two ethical issues they pose to our attention.
1) Due to the stakeholders of smokers, would be reasonable that it should be society as a whole to bear the burden for a diagnostic risk factor that the subjects could easily be avoided?
2) The PAP smears and mammograms do not distinguish between those most at risk and those less exposed to the possibility of contracting ovarian cancer and / or breast cancer. The reason that spiral CT should instead be carried out only in inveterate smokers is that this diagnostic test is very expensive. The cost of access to a medical practice, however, is not a good moral argument for excluding non-smokers from the possible benefits of a screening that could save his life. Unless it is proven that the risk of contracting lung cancer for nonsmokers is insignificant, it seems legitimate to non-smokers take up the spiral CT scan itself free (perhaps less frequently than smokers). After all limit the diagnostic service for smokers seems to be rewarding irresponsible behavior and punish (through taxation and spending may be supported in its) citizens who choose to abstain from risky behavior is known.
These two questions arise, as often happens, the encounter between the daily demands of care and the most advanced medical technologies. I hope that readers of this blog will intervene and say their subject.
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