Don’t wait for a doctor to suggest lung cancer screening

January 24, 2014 | by

Nearly 160,000 Americans die of lung cancer each year.

New U.S. Preventive Service Task Force recommendations for lung cancer mean most insurance will begin covering the screening within a year.

New lung cancer screening recommendations from the U.S. Preventive Services Task Force mean that most insurance plans will begin covering the screening within a year.

New lung cancer screening guidelines recommended by the U.S. Preventive Services Task Force in the last month could make a considerable dent in that number. The panel, which determines what therapies and tests must be covered by insurers under the Affordable Care Act, made final its July recommendation that current and former smokers between 55 and 80 years old who have smoked the equivalent of a pack of cigarettes a day for 30 years be screened with a low-dose CT scan.

Longtime smokers who are still smokers or who recently quit in the last 15 years should weigh their lung cancer  screening options now, says Dan Raz, M.D., co-director of the Lung Cancer and Thoracic Oncology Program at City of Hope.

“Even people who see their primary care doctor regularly need to be aware of this new screening,” Raz said. “Don’t wait for your doctor to suggest lung cancer screening. Ask yourself – or seek out a screening center that already screens for lung cancer.”

Raz said patients should seek these qualities in a lung cancer screening program:

  • Uses a low-dose CT scan. These scans – unlike chest X-rays – have proved effective in scientific studies at detecting lung cancer.
  • Offers smoking-cessation services. Catching lung cancer early is important in increasing the patient’s chances of survival – but minimizing risk by kicking the habit is also critical.
  • Knows how to accurately interpret the results of the screening, and a protocol for appropriate action. About a quarter of screenings will turn up some kind of nodule in the lung, Raz said. To avoid unnecessary invasive tests, patients should seek out screening centers with significant experience and expertise in screening for and treating lung cancer.
  • Works with a lung cancer multidisciplinary team. This should include radiologists, pathologists, pulmonologists, thoracic surgeons, oncologists, radiation oncologists and nurses. A team is required to coordinate screening, appropriate follow-up and treatment.
  • Complies with the best published practices for screening quality, radiation dose and diagnostic procedures.

The Lung Cancer Alliance lists centers of excellence for screening – including City of Hope.

“Lung cancer is by far the most common cause of cancer death among men and women in the U.S. and worldwide,” Raz said. “One of the reasons for this is that lung cancer is aggressive, and by the time a person experiences symptoms, it is often no longer curable.”

Lung cancer screening has the potential to change that. Without standard screening, only about 15 percent of lung cancers are detected at an early stage. Studies predict that with screening, about 80 percent of lung cancers could be detected at Stage 1, when they’re most easily treated.

The screening guidelines suggest annual screening for current or former smokers ages 55 to 80 who have a smoking history of 30 pack years. This means someone has smoked an average of one pack of cigarettes a day for 30 years – this could be a pack a day for 30 years or two packs a day for 15 years.
Raz says screening may also be important for those who smoked fewer years but have had other cancers, or who have a family history of lung cancer.

“If you catch your lung cancer early, you can be cured,” Raz said. “Be proactive about protecting your health.”