November is Lung Cancer Awareness Month. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. This is the perfect time to be proactive and find out how screenings can help. Read below to find out more about lung cancer screening CT from our own sub-specialty trained radiologist, Caleb Richards, MD (see photo above).
Why should I get a lung cancer screening CT?
• Lung cancer is the leading cause of cancer-related deaths in the United States and the world. Roughly 2.5 out of 10 cancer-related deaths are due to lung cancer. Simply put, lung cancer screening has been shown to decrease the risk of lung cancer related death. The goal of lung cancer screening is to detect the lung cancer at an early stage when it is easier to treat and cure.
Who is eligible for lung screening? Is it only for smokers?
• Lung cancer screening is intended for individuals who are at high risk for lung cancer. To be eligible for screening, someone has to meet the following criteria: age of 55-77, a current or former smoker, have quit within 15 years if a former smoker, and has at least a 30 pack year smoking history. Pack years is a way to measure how much someone has smoked through their lifetime. The way pack years is calculated is to multiply how many packs someone typically smokes in a day by how many years they have smoked. For example, someone who smokes 2 packs per day for 15 years has a 30 pack year history (2 PPD x 15 years = 30 years). As another example, someone who smoked one half of a pack per day for 60 years also has a 30 pack year history (1/2 PPD x 60 years = 30 pack years). Your doctor and health care team can also help you determine if you are eligible.
Are there any down sides to being screened? Does it hurt?
• There are benefits and risks with any medical test. The benefits of lung cancer screening are to detect early lung cancer and reduce your risk of lung cancer related death. The screening test does not hurt – it just requires you laying in a CT scanner to have images/pictures taken. These are done by “low dose” CT, meaning that the radiation is even lower than standard CTs, and is a really quick process. Some of the risks are that there are false positive or false negative results for the scan. A false positive means that you have a finding that is interpreted as suspicious for lung cancer, but later determined to not be lung cancer (for example, an area of infection or inflammation that mimics lung cancer). The patient should know that just because a CT scan is interpreted as abnormal does not necessarily mean that you have surgery or biopsy as the only next step. Often, further imaging is reasonable, such as a short term follow up CT scan, or a PET CT scan, neither of which are invasive. A false negative means that the lung cancer screening CT is interpreted as negative or not suspicious, but you later have an abnormality that develops into lung cancer. Adhering to annual screening can help prevent this and still catch abnormalities at an early stage.
Do I need an order from my doctor to schedule a lung screening?
• A doctor or provider has to order the lung cancer screening CT. However, before doing so, the patient and doctor should discuss the risks and benefits of lung cancer screening. While the benefits are quite clear, the risks of the study (discussed above), the patient’s baseline health, goals and values should all be considered before proceeding with screening. This coordination between the patient and provider is called “shared decision making,” and is a requirement before going forward with a lung cancer screening CT.
Where can I get my screening done?
• This is something that can be discussed with the ordering provider. Our outpatient imaging centers – Invision Sally Jobe – have an experienced team of technicians and radiologists that will guide you through the CT scan. A subspecialty trained radiologist will interpret your exam, and results and further recommendations will be sent to your doctor. From there, you will have guidance on whether to resume annual screening in 12 months, or if further action is needed in the event of an abnormal CT scan.