Should I be screened for lung cancer?
January 6, 2016
After many decades of extensive work on diagnosing and treating lung cancer, we still see a five-year survival rate of just 17 percent. To improve that rate, we must prevent the disease or detect it in its earliest stages.
Now, we finally have an opportunity to do so with low-dose computed tomography (CT) scans. This new screening process will change the future of lung cancer, and the potential to save lives is enormous.
Lung cancer is the leading cause of cancer death among men and women. The most common type – non-small cell lung cancer – sometimes can be cured if it is found early enough. In 2012, results were published from the National Lung Cancer Screening Trial involving 53,000 patients who were at high risk for lung cancer. Researchers found that the use of low-dose CT scans resulted in a 20 percent reduction of mortality.
Thanks to these encouraging results, Medicare and Medicaid began in 2015 to cover lung cancer screening. Many health insurance providers also provide full or partial coverage for those who qualify for the test.
Who should be screened for lung cancer?
Annual low-dose CT scans for lung cancer are covered by Medicare and Medicaid if you meet the following criteria:
- Age 55 to 77
- Smoked 30 pack-years (that is, a pack a day for 30 years, or two packs a day for 15 years, or the equivalent)
- Stopped smoking within the past 15 years, or currently smoke
- Have a written order from a physician asking for the CT scan
There are other risk factors in addition to tobacco use, such as chemicals, radon exposure, personal or family history of cancer, and exposure to secondhand smoke. Your health care provider can discuss these risk factors and assess whether the screening will help you.
Are there any risks with these CT scans?
Some of the possible risks with low-dose CT scans include:
- Anxiety for the patient
- False positives
- Radiation exposure
The major downside to these scans is they are so sensitive that they will identify a significant number of findings we will want to monitor. Most of the findings turn out to be benign. Some findings will require intervention. They may make you worry, and they may require more frequent scans or even a lung biopsy.
As with any CT scan, there is some exposure to radiation. Compared to conventional CT scans, low-dose CT scans are a much lower risk. We believe the screening process is safe, and we recommend that people follow the screening guidelines by the United States Preventive Services Task Force to increase their chances of early diagnosis.
Medicare/Medicaid coverage includes the cost of a physician visit for counseling and shared decision-making on the benefits and risks of lung cancer screening.
What is on the horizon for early detection of lung cancer?
We are part of clinical studies to develop blood tests to complement the low-dose CT scan results. We are optimistic that the combination will enhance the effectiveness of the screening process.
In the future, we may be able to fine-tune the screening process to include more frequent screening and evaluation of the patients we determine are at the highest risk.
Let me make one thing clear – lung cancer screening is not an alternative to quitting smoking. Quitting smoking and avoiding other harmful exposures remains the cornerstone of lung cancer prevention and risk reduction. We have a nicotine cessation program to help people who smoke, vape, or chew tobacco. We offer individual counseling both on the phone and in person, support groups, and access to prescriptions for medications to help you quit. There is no cost and you can join at any time. For more information and enrollment, call our Cancer Answer Line at 1-888-980-6050.
Right now, more than two-thirds of our patients are diagnosed at an advanced stage of lung cancer, making treatment very difficult. If we can flip that to diagnosing most of our patients at an early stage, that will have a tremendous impact on lung cancer outcomes.
Ultimately, it’s about saving lives from this devastating disease. Prevention, risk reduction including nicotine cessation, and early detection will help us improve both survival rates and quality of life.