Are You at Risk for Lung Cancer?

National Lung Screening Trial Shows Low-Dose CT Scan Reduces Mortality Rates

If you are a smoker or former smoker, you probably know you have an increased risk of getting lung cancer. Other factors like environmental exposures can also raise your risk. If you are at risk, you may want to consider getting screened for the disease with a low-dose CT scan of the chest, available at Washington Hospital. National Lung Screening Trial results show that the scan can reduce your risk of dying from this deadly form of cancer by 15 to 20 percent.

“Up until now we didn’t have a test that was shown to reduce lung cancer mortality rates,” said Dr. Jason Chu, a local pulmonologist and member of the Washington Hospital medical staff. “But thanks to the National Lung Screening Trial, we now know that screening with a low-dose helical CT scan of the chest can actually lower your chances of dying from lung cancer.”

More than 221,000 people will be diagnosed with lung cancer this year in the U.S., and 7 in 10 will die from the disease, according to the National Cancer Institute. While lung cancer accounts for only 13.3 percent of new cancer cases, it is the cause of 26.8 percent of cancer deaths, making it the most deadly form of cancer. In fact, more people die from lung cancer each year than from breast, prostate and colon cancer combined.

“You have a much better chance of surviving lung cancer if you are diagnosed at an early stage,” Dr. Chu explained. “The low-dose CT scan can help physicians detect and diagnose lung cancer earlier, when more effective treatment options are available. We are on a mission at Washington Hospital to diagnose lung cancer at the earliest stage possible to save lives.”

Who Should be Screened?

Dr. Chu said smoking is by far the leading cause of lung cancer. Those who should be screened with a low-dose CT scan include current or former smokers with a smoking history of 30 “pack years” (an average of one pack a day for 30 years). If you are a former smoker, you need to have quit within the last 15 years.

“Even if you don’t meet the criteria, you still may be a candidate,” he said. “If you have a 20 ‘pack year’ history and have been diagnosed with underlying pulmonary diseases like chronic obstructive pulmonary disease or pulmonary fibrosis, or have been exposed to asbestos, radon, silica, cadmium, arsenic, beryllium, chromium, diesel fumes or nickel, you should talk to your physician about getting screened.”

The low-dose CT screening is covered by Medicare if you meet the following criteria: are ages 55 to 77, have a smoking history of at least 30 “pack years,” and have a written order from a physician. For those who meet the criteria, Medicare also covers a visit with your doctor about the benefits and risks of lung cancer screening.

CT Scan is Effective

The National Lung Screening Trial looked at the effectiveness of low-dose CT scans compared to a chest x-ray across 33 sites nationwide. The CT scan captures a multiple-image scan of the chest while an x-ray produces a single image of the chest. Both are painless procedures with minimal risks.

The trial consisted of 53,000 current or former heavy smokers ages 55 to 74 screened over a two-year period and who were followed for another five years. A low-dose CT scan was used as the screening tool for half, while x-ray was used for the other half, Dr. Chu explained.

Among those who received the low-dose CT scan, almost a quarter of screenings were detected to be abnormal, while 7 percent of chest x-ray screenings were abnormal. Of these abnormal screenings, low-dose CT was able to positively identify two to three times as many lung cancers than x-rays. Also, more low-dose cancers were detected at earlier stages than with x-ray.

According to Dr. Chu, participants with abnormal screenings were given additional tests to determine if they actually had cancer, including in some instances invasive procedures like a bronchoscopy. Of those who received an abnormal CT scan result, 25 out of 1,000 had an invasive procedure compared to seven out 1,000 who had an invasive procedure with an x-ray.

“The risk of having an unnecessary invasive diagnostic procedure with a low-dose CT scan is higher, but the risk is still very low,” Dr. Chu said. “Low-dose CT scans save lives. When the numbers were crunched, there were 20 percent fewer deaths with patients screened with the low-dose CT scan.”

He encouraged those who are at high risk for lung cancer to discuss the screening with their physician to learn more about the benefits and risks. To schedule an appointment with a pulmonologist, call (800) 963-7070 for a physician referral.

For information about other programs and services offered at Washington Hospital that can help you stay healthy, visit www.whhs.com.