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Lung cancer Screening

Lung cancer kills more Americans than the next four leading cancers combined, including breast, colon, pancreatic and prostate cancers. Each year, close to 160,000 people die of lung cancer.

Early detection of lung cancer is important. It leads to increased survival rates and a decrease in lung cancer related deaths. Cure rates improve when lung cancer is detected and treated in its earliest phase. Early detection can increase the 5-year survival rate for a detected stage I lung cancer to nearly 90%.

National lung screening trial (NLST)

The NLST studied individuals at high risk for lung cancer. It showed that annual low-dose computed tomography (CT) of the chest can save lives.

What the trial found:

  • One life was saved for every 320 high-risk persons screened. Low dose CT screenings resulted in a 20 percent lung cancer-specific mortality benefit versus annual chest X-rays.
  • Annual lung cancer screening benefits exceeds the benefits of breast cancer screening

Medicare coverage

Medicare covers yearly lung cancer screening with low dose CT for qualifying individuals. Beneficiaries must meet these criteria:

  • Be 55-77 years of age
  • Are either current smokers or have quit smoking within the last 15 years
  • Have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years)
  • Have a written order from a physician or qualified non-physician practitioner. The order must meet specific Medicare requirements

Medicare coverage includes:

  • A counseling visit
  • Shared decision-making on the benefits and risks of lung cancer screening

Data collection

Medicaid screenings data is shared with the National Lung Screening Trial. This data includes specific coverage eligibility criteria for radiologists and radiology imaging centers. The data collected is determined by:

  • The National Lung Screening Trial protocol
  • U.S. Preventive Services Task Force recommendations
  • Multi-society multi-disciplinary stakeholder evidence-based guidelines.

Screening risks

It is also important to know that, as in any screening, there are risks:

  • “False positive” findings: CT scanners can see “spots” on the lung as small as a grain of rice. If the scan picks up any findings suspicious for lung cancer, it is called a “positive screen.” About 95% of these “spots” are not cancer and do not require a biopsy. However, this may require repeating the scan at defined intervals to look for changes in size and shape of the “spots”.
  • Anxiety: If cancer is suspected, additional testing will be required to confirm the results. Anxiety during this process is common.
  • Unnecessary surgery: Even with all these precautions, some nodules - about 0. 5% - that are not cancerous may end up being removed by unnecessary surgery. All lung surgery carries significant risk and after effects.
  • Radiation exposure: Some people worry about radiation exposure from lung cancer screening. Screening scans that check people who have no symptoms for lung cancer are given at low dose. This means that the level of radiation used is very low; it is similar to the radiation dose in a mammogram. Follow-up scans that may have to be done to determine if any change or growth has occurred are at the same low-dose.

Our multidisciplinary lung nodule team will work closely with your medical provider to avoid unnecessary biopsies and maximize the benefits of lung cancer screening.