Lung cancer is the number one cause of cancer-related deaths in the United States and the majority of patients present at an advanced stage when the disease is incurable. It is estimated that over 80% of lung cancer could be cured if detected early and surgically resected.
In February of 2015, Medicare announced that it would pay for an annual CT screening for high-risk smokers. Since this announcement, there has been a lot of confusion about who could benefit from a lung cancer screening. To date, there has been a slow implementation of this screening recommendation in the community and only a small percentage of all eligible patients are receiving their annual CT screening.
Foremost, we must remember why lung cancer screening is so important. In the largest lung cancer screening trial, 50,000 people aged 55 to 74 who were current or former smokers (who had not quit more than 15 years ago), and had at least least a 30 pack year smoking history (equal to a pack a day for 30 years or 2 packs a day for 15 years) were randomized to three annual low-dose CT screening tests or Chest X-rays (CX-ray). The people who got a low-dose CT had a 16% lower chance of dying from lung cancer than those who got a CX-ray screening because their cancers were detected early and they were able to get the proper surgery.
So if lung cancer CT screening can save lives why is it used so infrequently? One major disadvantage of CT screening is that it can detect a lot of abnormalities that turn out not to be cancer but prompt doctors to order additional tests and invasive procedures like lung biopsies. Many patients are also concerned about the risk that comes from increased exposure to chest radiation with this screening test.
To decrease the risks associated with this screening test, the American Cancer Society and Medicare recommends that doctors discuss the risks and benefits for each patient and that only high risk patients (age 55-74 with a smoking history equivalent to a pack a day for 30 years) and those who are currently smoking or quit in the last 15 years be considered for this test. It is also recommended that the CT screening test be performed at an accredited institution with experience interpreting these tests and access to lung cancer specialists and comprehensive follow up care.
In summary if you are:
- A current or former smoker
- And in the age group from 55 to 74 years
- And have a smoking history of at least 30 pack years (this means a pack a day for 30 years or the equivalent)
You are in a high-risk category for lung cancer and should discuss low-dose CT screening with your primary care doctor.
Tomorrow, November 18th, the Mount Sinai Comprehensive Cancer Center will host its third Annual “Shine a Light on Lung Cancer” event in partnership with the Lung Cancer Alliance. The event has grown into the largest nationally and internationally coordinated awareness event for lung cancer with over 200 vigils taking place during the month of November to recognize Lung Cancer Awareness Month. This year’s event “A New Era of Hope in Lung Cancer” highlights the advances in screening, radiotherapy and immunotherapy. This is a very exciting time in lung cancer treatment! For the first time, and after much advocacy, the CT lung cancer screening is now being covered by most insurances. This enables physicians to detect lung cancer in their patients at its earliest, most curable stages.
For more information about the Mount Sinai CT lung cancer screening or to schedule an appointment, please call 305-535-3434.