Screening For Lung Cancer
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Screening For Lung Cancer
Please Share with Your Friends Who Smoke
Lung cancer is the leading cause of death from malignancy in the United States. It kills more people than breast cancer, colon cancer, cervical cancer, and prostate cancer. We screen for those, but we don’t screen for lung cancer. It makes no sense, especially since screening is so easy. It only takes ten minutes. It just involves a low dose CT scan of the chest without any contrast, and it comes with an added bonus. This scan shows calcium in the heart arteries and identifies patients with heart artery trouble who should be on optimal medical treatment for their vascular disease.
Screening is especially important since lung cancer is so deadly. When it is discovered late, only about 5% of patients are alive in five years. When it is discovered early with a scan, the cure rate is 95%. (stage 1A)
“Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years”.
1. Assess risk based on age and pack-year smoking history: Is the person aged 50 to 80 years and have they accumulated 20 pack-years or more of smoking?
a. A pack-year is a way of calculating how much a person has smoked in their lifetime. One pack-year is the equivalent of smoking an average of 20 cigarettes—1 pack—per day for a year.
2. Screen: If the person is aged 50 to 80 years and has a 20 pack-year or more smoking history, engage in shared decision making about screening.
a. The decision to undertake screening should involve a discussion of its potential benefits, limitations, and harms.
b. If a person decides to be screened, refer them for lung cancer screening with low-dose CT, ideally to a center with experience and expertise in lung cancer screening.
c. If the person currently smokes, they should receive smoking cessation interventions.
3. How often?
a. Screen every year with low-dose CT.
b. Stop screening once a person has not smoked for 15 years or has a health problem that limits life expectancy or the ability to have lung surgery.
If you are at high risk of lung cancer, make sure you are screened. It may save your life!
Screening For Lung Cancer
I appreciate your Substack, Doc. So I am thinking about the people who have died from lung cancer, yet never smoked. Christopher Reeve’s wife, Dana, comes to mind… And the former governor of Virginia, John Dalton. I’m sure there are many many other examples, these are just ones that came to mind right away. What about those folks??? Shouldn’t everybody be screened? Should you only be screened if you exhibit certain symptoms? If so, what are the symptoms? After a certain age, say 40, wouldn’t a scan be a good idea, giving you cardiac calcium info and whatever is going on in your lungs.
I had a cardiac calcium scan a couple years ago, it never occurred to me to. think about if they could see anything with my lungs… hopefully the doctor reading the scan would include observations about the lungs if he saw anything...
I remember the tech let me look at the scan after it was done, and I was very concerned about some white areas I saw… She said, “those are your ribs .” 😅