Will a Lung Cancer Screening Prevent Death?
Did you know lung cancer is the third most common type of cancer and is the leading cause of cancer death despite many advances in care?
Smoking is the greatest risk factor for lung cancer, with approximately 85% of all lung cancers being attributed to a smoking history. This relationship was first described by one of Ochsner’s founding fathers, Dr. Alton Ochsner, in 1939.
From 2003 to 2004, Ochsner was a participant in The National Lung Screening Trial, which enrolled more than 50,000 high-risk patients with a significant smoking history, to determine if lung cancer screening could prevent deaths from the disease. The results of the study were reported in the New England Journal of Medicine in August 2011.
- The study looked at two different screening tools to detect lung cancer. Each patient had either a chest X-ray or a CT screen of the chest.
- Patients who had a low radiation dose CT of their chest and were diagnosed with lung cancer had a 20% reduction in mortality rate.
- Since this study was published, several societies have recommended annual low dose CT scan for asymptomatic lung cancer patients who are current or former smokers between the ages of 55 to 80.
- In 2014, The U.S. Preventive Services Task Force recommended lung cancer screening for all current or former smokers who had the ability or willingness to undergo lung biopsy and/or surgery.
What are the risks of a CT scan of your chest?
- It is important to discuss risks for every test with your physician.
- The CT will expose you to a low dose of radiation, equivalent to approximately half the exposure that people are exposed to naturally in the environment over a one-year time period.
- False-positive results: The respiratory system is constantly being exposed to the environment, and our bodies’ natural reaction is to contain something that can potentially harm you. That results in the formation of a “granuloma.” Granulomas form nodules, or spots on your lungs and are quite common. In Ochsner’s screening program, approximately 50% of our patients have small nodules that are most likely benign (not cancer).
- Between 3% to -5% of all nodules detected are proven to be lung cancer.
- Other disease processes may also be found. For example, emphysema or coronary artery calcification.
What happens when a suspicious nodule is found?
- The most concerning finding is the larger nodules, greater than 8mm, which may represent early lung cancers. Imagine stacking four nickels on top of each other. The height of the stack is 8mm. Depending on the size of the nodules, radiologists and lung cancer specialists will make recommendations on the best way to manage suspicious nodules, which may include:
- Monitor with additional CT scans over a two-year time period (around 2-3 additional scans when nodules are less than 8mm in size).
- Surgery to have it removed.
Screening for high risk individuals dramatically improves lung cancer survival rates. An estimated 8 million Americans qualify as high risk for lung cancer and should receive an annual screening. The earlier this disease is detected, the higher the rate of survival.
At Ochsner, we have lung cancer multi-disciplinary teams that include nurses, surgeons, pulmonologists, oncologists and radiologists who are available to review all suspicious nodules with our lung cancer screening navigators when requested.