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How important is screening for lung cancer?

Dr. Laki J. Rousou, MD
Cardiothoracic Surgeon

Screening for lung cancer is important because it can help extend the lives of current and former smokers who develop lung cancer by guiding them to lifesaving interventions. Cigarette smokers make up about 90 percent of those who get lung cancer. The best way to avoid lung cancer is to stop smoking—or never start in the first place. Even former smokers are at an increased risk of developing lung cancer, which is one reason why screening is so important.

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Dr. Claudia I. Henschke, MD
Diagnostic Radiologist

Because lung cancer has no symptoms in its early stages, more than 85 percent of the men and women who are diagnosed with lung cancer today are diagnosed in a late stage, after symptoms have occurred and when there is very little chance of cure. As a result, approximately 95 percent of the 173,000 people diagnosed each year die from the disease.

Dr. Raja M. Flores, MD
Cardiothoracic Surgeon

Lung cancer screening results in more lives saved because it catches lung cancer early. Lung cancer screening is important for at risk groups.

Lung cancer screening saves lives. The American Cancer Society estimates that more than 221,000 new lung cancer cases will be diagnosed in 2015 in the U.S., and more than 158,000 people will die from the disease—more than from any other cancer. Studies have shown that lung cancer screening with low-dose computed tomography (LDCT) can reduce lung cancer mortality in high-risk patients by 20 percent.

A screening program should use a standardized reporting system and have input from board-certified cardiothoracic surgeons as part of a multidisciplinary team evaluating computed tomography (CT) scan findings. Minimizing the number of operations for benign disease and maintaining a low morbidity and mortality for surgical resection will help realize the full benefit of lung cancer screening in its widespread adoption in clinical practice.

When some critics had concerns about false-positive results leading to unnecessary treatment, researchers from Lahey Hospital & Medical Center in Burlington, Mass., reviewed the surgical outcomes of 1,654 patients who underwent LDCT lung cancer screening.

The screenings were performed from January 2012 to June 2014 at the research team’s clinic. Surgical intervention for a non-lung cancer diagnosis was rare—5 out of 1,654 patients, or 0.30 percent. That incidence is comparable to the 0.62 percent rate found in the National Lung Screening Trial that helped secure screening coverage in the U.S. Only four of the 1,654 patients (0.24 percent) had surgical intervention for benign disease.

Of the 1,654 patients screened, 25 (1.5 percent) underwent surgery. Twenty patients were diagnosed with lung cancer; 18 (90 percent) had early stage disease with a high probability of being cured.

Private insurers and the Centers for Medicare & Medicaid Services cover LDCT lung cancer screening for select patients.

Screening for lung cancer is an important and effective tool. The National Lung Screening Trial (NLST) was a large clinical trial that looked at using a low-dose computerized tomography (CT) scan to screen for lung cancer. The study showed that lung cancer screening for patients at high risk can detect cancer at an early stage and help prevent one in five deaths from lung cancer.

A CT scan is more likely to show lung tumors than routine chest x-rays. A CT scan can also provide precise information about the size, shape and position of any lung tumors and can help find enlarged lymph nodes that might contain cancer that has spread from the lung.

Dr. Darria Gillespie, MD
Emergency Medicine Specialist

Nothing is more effective for reducing lung cancer deaths than smoking cessation. However, for those who are at high risk (those who meet all three criteria: age 55-74, have 30 year or greater pack-year history of smoking, and currently still smoke or quit in the last 15 years), screening annually with low-dose Chest CT has shown a 20 percent decrease in mortality from lung cancer due to earlier diagnosis.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.