Early Screening for Lung Cancer
May Save or Extend Your Life
by Walter Silbert, MD
Lung cancer is the leading
cause of cancer death in both men and women in the U.S. One of the reasons it
remains so lethal is that lung cancer is not typically discovered until a
patient develops symptoms. At this late stage of the disease, lung cancer is
very difficult to treat successfully. However, when it is detected early in the
disease process—before the onset of symptoms—it is more responsive to treatment
and patients often have a longer life expectancy.
In December 2013, the U.S.
Preventative Services Task Force (USPSTF) issued a recommendation statement on
annual screening for lung cancer with low-dose computed tomography (LDCT).
The recommendation applies
to adults at high risk for developing the disease because of their smoking
history and age. In response to these recommendations, Cayuga Medical Center has
implemented an annual lung-screening program, the goals of which are to identify
patients with an increased risk of lung cancer, counsel them on smoking
cessation, and screen them annually for early stage tumors.
This new screening tool is
painless, noninvasive, and similar to the use of mammography in annual breast
cancer screening, which has proven very successful in identifying early-stage
cancers and has reduced fatalities from breast cancer.
1) What do I need to know
about annual lung screening?
The USPSTF recommends annual
screening for lung cancer with LDCT in adults aged 55 to 80 years old who have
a 30-pack-year smoking history. If you meet this criteria and you currently
smoke, or if you quit less than 15 years ago, annual screening is recommended.
What is the definition of
the term 30-pack-year?
If you have smoked a pack of
cigarettes a day, every day, for 30 years, you have a 30-pack-year smoking
history. If you smoked two packs a day, every day, for 15 years, you also have
a 30-pack-year smoking history. This calculation is clinically important
because there is a direct relationship between magnitude of cigarette smoking
and the risk of lung cancer.
2) Are there any risks
associated with LDCT?
The biggest concern related
to LDCT screening is a certain percentage of false-positive results, which
occur when the screening test results indicate there may be cancer when there
is not. To best mitigate this we follow detailed guidelines in the appropriate
evaluation and follow-up of indeterminate lung nodules detected during LDCT.
However, false-positive results do occasionally occur and they typically lead
to further imaging studies and additional testing that may prove to be
unnecessary in retrospect. As caretakers we understand that this also leads to
anxiety on the part of patients, and we do everything we can to keep
false-positive findings to a minimum.
3) What happens after my physician
has referred me for LDCT lung screening?
Once your screening exam has
been completed the radiologist sends a report to your primary-care provider,
who shares the results with you. If the results are positive, you and your
physician will discuss what comes next. At Cayuga Medical Center we utilize
experienced patient navigators, who are specially trained nurses, to help
answer your questions. Additional patient resources at Cayuga Medical Center
include the Cayuga Cancer Center for comprehensive cancer care, board-certified
pulmonologists with special training in diagnosing and treating diseases of the
lung, and the Cayuga Center for Healthy Living for help with smoking cessation
and other life-style changes.
4) Does my health insurance
cover the cost of annual lung screening?
Every insurance policy is
different so it is best to verify with your health insurance carrier what the
approved criteria are for annual lung screening using LDCT. If this screening
is not covered under your insurance program, Cayuga Medical Center offers it as
a self-pay service. If you think you meet the criteria for lung cancer
screening, I urge you to talk with your primary care physician or call (607)
274-3937 to speak with one of our nurse navigators for further information.
Dr. Silbert is board
certified in diagnostic radiology and is on the medical staff of Cayuga Medical
Center, where he is director of musculoskeletal radiology services.
Save the Date: You are
invited to “Shine The Light”, a free event being held for lung cancer
survivors, patients, family and friends on November 19th from 5pm to
7:30pm at Cayuga Medical Center’s Garden Café.