Category: Oncology Imaging

Cancer Screening at ASCO 2025

Posted on by Brian Casey

The American Society of Clinical Oncology’s annual meeting isn’t usually known for diagnostic radiology research. But this week’s conference in Chicago included a number of radiology-related studies, particularly regarding cancer screening. 

Most ASCO meetings are dominated by new chemotherapy advances. 

  • But oncologists maintain a strong interest in cancer screening as the first step to guiding patients into advanced treatments.

At ASCO 2025, screening disparities were at the top of the agenda, as evidenced by the following presentations …

  • Mobile mammography addressed healthcare disparities for both urban and rural women in a study that analyzed demographics from 8.3k women screened. 
  • Patients served by mobile mammography in Pennsylvania were more likely to be Black (68% vs. 40%), uninsured (71% vs. 2.1%), and live in an economically deprived area (70% vs. 27%), and they also had higher recall rates (19% vs. 9.9%) and twice the median days to case resolution (29 vs. 14 days).
  • U.S. women who didn’t get mammography screening tended to be younger, uninsured, and have issues with medical costs.
  • Farther afield, Uzbekistan’s new breast screening program was described, with 83.6k women screened and 80% of cancers detected at an early stage.
  • The program also uses AI, with AI achieving higher AUC than a three-radiologist average (0.89 vs. 0.82) while reducing workload 41% with 3X lower recall.
  • In Saudi Arabia, AI was used to audit mammography reports for quality and compliance with BI-RADS guidelines. 
  • A virtual-first approach in California successfully reached candidates for colorectal and CT lung cancer screening, using an online platform with educational resources and scheduling. Of 71 people who met lung screening criteria, 24% completed CT scans, and of these 29% had clinically significant findings. 
  • To improve CT lung screening among low-income people of color, Indiana researchers enrolled 89 screening-eligible people in an educational program. Before the program 56% had never heard of lung cancer screening, but afterwards 100% said they believed screening could save their lives.
  • Ohio researchers found that of 116 lung cancer cases in a tumor registry, 24% got low-dose CT lung screening.
  • An IT tool detected patient concerns about screening’s cost – AKA financial toxicity – and assigned financial navigators to help them. 

The Takeaway
This week’s ASCO 2025 sessions demonstrate the synergy between screening and treatment that’s improving survival for a broad spectrum of cancer patients. Continued progress will only serve to benefit both disciplines.

Screening Takes Center Stage at ECR 2025

Posted on by Brian Casey

New advances in cancer screening were among the major trends at last week’s ECR 2025 conference in Vienna. From traditional screening exams like mammography to up-and-coming tests like CT lung cancer exams, radiologists are emerging at the forefront of efforts to improve population health through early detection.

CT lung cancer screening is gaining momentum in Europe, and a Friday afternoon session explored the experiences of multiple sites…

  • U.K. researchers used DeepHealth’s Lung Nodules AI solution for automated triage of lung nodules found on non-screening CT chest exams, finding the approach could save £25k-£37k annually.
  • A German team documented technical lung CT acquisition parameters for screening centers in the SOLACE consortium across 10 countries, finding some room for improvement. 
  • Preliminary results from an Italian lung screening project were reported, with 2k people scanned with a 1.5% cancer detection rate (77% stage I-II) and 17% recall rate. Smoking cessation advice was also given.
  • Early results from a pilot screening project in Poland were given, with a 1.9% cancer detection rate in 3.1k people screened. They recommend screening be implemented nationwide. 
  • In a secondary analysis of 23.4k people in the NLST study, CT-derived body composition metrics predicted mortality beyond traditional risk factors.

Meanwhile, new ECR cancer screening research builds on the landmark accomplishments from 2024 in AI for breast screening. A Saturday afternoon session explored the progress being made…

  • German breast screening programs that deployed ScreenPoint Medical’s Transpara AI algorithm for 119k women saw their cancer detection rate grow (6 vs. 4.8 cancers per 1k) while the recall rate remained stable at around 2.5%. 
  • AI-supported double-reading in Italy for 120k women led to more breast cancers detected on baseline exams compared to subsequent screening rounds, as well as a 42% lower recall rate.
  • Patients found an AI chatbot based on GPT-4 generated responses to their questions that were more empathetic and readable than those of radiologists.
  • Another Italian study found that using AI for double-reading mammograms of 266k women led to a 21% increase in cancer detection rate and 15% drop in recall rate.
  • A secondary analysis of the MASAI trial suggested that double-reading with two radiologists continue to be used for high-risk women. Single reading of 3.8k high-risk exams resulted in 8.9% fewer detected cancers and 5.9% fewer recalls.

The Takeaway

Last week’s research on cancer screening at ECR 2025 shows that imaging experts see screening as a way to not only improve population health on a broad scale, but also to give radiologists the opportunity to raise their profile with patients and take a more direct role in patient care. The question is whether it’s an opportunity radiologists are ready to take.

Screening Foes Strike Back

Posted on by Brian Casey

Opponents of population-based cancer screening aren’t going away anytime soon. Just weeks after publication of a landmark study claiming that cancer screening has saved $7T over 25 years, screening foes published a counterattack in JAMA Internal Medicine casting doubt on whether screening has any value at all. 

Population-based cancer screening has been controversial since the first programs were launched decades ago. 

  • A vocal minority of skeptics continues to raise concerns about screening, despite the fact that mortality rates have dropped and survival rates have increased for the four cancers targeted by population screening.

This week’s JAMA Internal Medicine featured a series of articles that cast doubt on screening. In the main study, researchers performed a meta-analysis of 18 randomized clinical trials (RCTs) covering 2.1M people for six major screening tests, including mammography, CT lung cancer screening, and colon and PSA tests. 

  • The authors, led by Norwegian gastroenterologist Michael Bretthauer, MD, PhD, concluded that only flexible sigmoidoscopy for colon cancer produced a gain in lifetimes. They conclude that RCTs to date haven’t included enough patients who were followed over enough years to show screening has an effect on all-cause mortality.

But a deeper dive into the study produces interesting revelations. For CT lung cancer screening, Bretthauer et al didn’t include the landmark National Lung Screening Trial, an RCT that showed a 20% mortality reduction from screening.

  • With respect to breast imaging, the researchers only included three studies, even though there have been eight major mammography RCTs performed. And one of the three included was the controversial Canadian National Breast Screening Study, originally conducted in the 1980s.

When it comes to colon screening, Bretthauer included his own controversial 2022 NordICC study in his meta-analysis. 

  • The NordICC study found that if a person is invited to colon screening but doesn’t follow through, they don’t experience a mortality benefit. But those who actually got colon screening saw a 50% mortality reduction.  

Other articles in this week’s JAMA Internal Medicine series were penned by researchers well known for their opposition to population-based screening, including Gilbert Welch, MD, and Rita Redberg, MD.

The Takeaway

There’s an old saying in statistics: “If you torture the data long enough, it will confess to anything.” Among major academic journals, JAMA Internal Medicine – which Redberg guided for 14 years as editor until she stepped down in June – has consistently been the most hostile toward screening and new medical technology.

In the end, the arguments being made by screening’s foes would carry more weight if they were coming from researchers and journals that haven’t already demonstrated a longstanding, ingrained bias against population-based cancer screening.

Get every issue of The Imaging Wire, delivered right to your inbox.

You might also like..

Select All

You're signed up!

It's great to have you as a reader. Check your inbox for a welcome email.

-- The Imaging Wire team

You're all set!