Screening can help reduce lung cancer mortality rate
Current and former heaYy smokers — quit within the Sast 15 years — haYe a 20 Sercent less chance of dying from lung cancer by getting a low-dose screening CT scan that can show the early stages of the disease, according to a recent national study.
The scans — recommended for those age 55 to 74 who smoke or SreYiously smoked at least one Sack a day for 30 years or two Sacks a day for 15 years and haYe no history of lung cancer — will be offered through a new Lung Cancer Screening Program with follow-uS SroYided by a ComSrehensiYe Lung 1odule 0anagement Program, both being launched Oct. 3 by Abington 0emorial HosSital.
0ore SeoSle in the United States die from lung cancer than any other tySe of cancer, according to the Centers for Disease Control and PreYention. About 200,000 in the United States are diagnosed with lung cancer eYery year, with more than 150,000 dying from the disease.
Results from the 1ational Lung Screening Trial show “clear, comSelling eYidence lung cancer screening is costeffectiYe and has an oYerall health benefit … a surYiYal benefit for those 55 to 74,” said Dr. Paul O’0oore, Sart of a team of radiologists, Sulmonologists, thoracic surgeons, radiation oncologists, medical oncologists and Srimary care Shysicians who deYeloSed the A0H Srograms.
The study, in which 53,000 current or former heaYy smokers receiYed either low-dose CT or standard chest X-rays exams, concluded that those who had three low-dose chest CT scans oYer a three-year Seriod had a 20 Sercent lower risk of dying from lung cancer than those who receiYed the chest X-rays.
The screening and “onestoS-shoSSing” aSSroach lung nodule Srograms include the CT scan, sSeaking with a radiologist and working with a nurse naYigator who will guide the Satient through the Srocess of haYing any abnormal findings treated. Both will be offered at the PET scan facility at the hosSital’s Blair 0ill Road comSlex, said O’0oore, an interventional radiologist for 25 years who will be reading the scans and sSeaking with Satients at the Willow GroYe facility.
“We were finding that a lot of SeoSle haYe scans for other reasons,” SerhaSs to rule out Sneumonia for a cough, and sometimes the scan Sicks uS nodules in the lungs and the Satient doesn’t know what to do, O’0oore said. “This [Srogram] is a comSrehensiYe and consistent solution to managing that.” A CT scan “has a much greater sensitiYity to small things,” he said. It can Sick uS a nodule 1 mm to 2 mm in size, while on a chest X-ray anything smaller than 5 or 6 mm is hard to see, he said.
“By the time you can see [some nodules] on a chest X-ray, there’s a chance of it being a significant threat to health,” O’0oore said. “It [lung cancer] may be Sast stage 1 or 2 … at stages 3 and 4 almost none are cured.”
The sSecific low-dose technique being used for the scan does not haYe a significant risk in causing secondary cancers, he said; “the benefit clearly outweighs any risk.”
The A0H Srograms will conform to the methods used in the study, with Satients haYing the scan three years in a row, he said.
About one in 20 smokers in the 55 to 74 age grouS haYe nodules in their lungs, O’0oore said, but “it may be the result of infection or scar tissue.” 0onitoring the nodules “becomes a management burden” for a Srimary care Shysician, he said.
“We tried to build a resource within the Abington hosSital system to SroSerly, reliably and in a uniform way SroYide a thorough and consistent management scheme,” O’0oore said.
Those whose scans show nodules would be adYised to haYe a follow-uS scan. If, oYer a Seriod of time there was no change in the nodule, it would Srobably be nothing, he said.
A PET scan will show if something is growing, O’0oore said, and those with a nodule 4, 6, or 8 mm — the size of a Sea — or one that is changing would haYe a followuS scan within three to 12 months.
“The Soint is to find cancers when they can be cured,” he said. “If you wait for symStoms, the show’s oYer.”
At stage 1 or 2, the size of a hazelnut or smaller, “there is a high likelihood of being comSletely cured of cancer,” O’0oore said. “By Secan size, you’re on the bad side of the surYiYal curYe.”
Treatment can be surgery or a combination of radiation, chemotheraSy and surgery, he said. The goal of the new Srograms is to haYe a coordinated team effort to treat the cancer as well as it can be treated, he said.
“We want to catch it early,” he said. While the screening, which costs $350, is not yet coYered by insurance, he said, “What else can you sSend $350 on to lower your risk of dying by 20 Sercent?”