But in reality, the findings show that lung cancer is very rarely the cause of pneumonia, he said.
Mortensen said that the extra radiation given by a single chest X-ray is not a lot, but that it might as well be avoided if possible. In addition, he said, when more people who probably don't have lung cancer get chest X-rays, "We're going to find things that aren't really there," leading to more unnecessary tests or even treatment in people who don't have cancer.
"We should really figure out which populations are at risk for lung cancer and those are the ones we should be aiming (X-rays) at," …

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That suggests chest X-rays should only be done on pneumonia patients 50 years and older in order to reduce the number of X-rays done on people who are very unlikely to have lung cancer, the authors write in Archives of Internal Medicine.
They add that the cost of a chest X-ray in Edmonton is about $35, so imaging only the patients over 50 would cost $1,250 "per lung cancer detected," versus $2,125 when all pneumonia patients get X-rays.
Guidelines recommend that pneumonia patients be checked for lung cancer because the two may be closely linked.
"One of the reasons people get …

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Just over 1 percent of all the pneumonia patients (36 people) were diagnosed with lung cancer based on an X-ray during those 3 months - which increased to 2.3 percent (79 people) with X-rays given over the next 5 years. No patients younger than 40 got lung cancer during those 5 years of follow-up.
The researchers calculated that if all patients had been given a chest X-ray soon after pneumonia treatment, 1.7 percent of them would have been diagnosed with lung cancer. If doctors limited chest X-rays to patients 50 and older, just one case of lung cancer would have been missed and close to 3 …

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