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• Debate continues over diagnostic scans for lung cancer  

For the 42 percent of Americans who smoke cigarettes or once did, a ruling from the state's highest court last month seemed to offer hope that a simple screening tool could help them ward off advanced lung cancer.

The judges decided that Philip Morris USA may have to pay for lung scans for smokers so they can get early warning if they've developed cancer - and get treatment before it spreads into a deadly mass. (A federal court would have to affirm the state's decision before the company would have to pay.)

Even before the court weighed in, advocates had been pressing politicians for money to pay for CT scans for high-risk but asymptomatic people - insurers generally don't cover the test for screening - particularly since a group of New York researchers published results in 2006 suggesting that screening is saving the lives of smokers, former smokers, and people exposed to secondhand smoke and other hazards, such as asbestos. Some smokers are so convinced of the benefits of CTs they pay the $400 screening fee themselves.

"Our movement is really taking hold,'' said Joanne O'Connor, cochair of the Lung Cancer Alliance in Massachusetts, which is lobbying legislators for funding. "I wouldn't want to find out [I had lung cancer] like my sister did when she was already stage four. She died six months later.''

But even as pressure for CT scanning builds, many of the country's top cancer specialists are saying not so fast. . . .

The Massachusetts Supreme Court relied in part on Miller's expert testimony during the lawsuit brought against Philip Morris by two Massachusetts smokers. Since the 2006 study was published, however, the New England Journal has published three corrections, including one from Henschke revealing that some of the funding for the study came from cigarette-maker Liggett Tobacco.

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