Did you know that more Americans die from lung cancer than any other cancer? It is the second-most commonly diagnosed cancer in both men and women. Yet it is also the most preventable cancer, and it is treatable if detected early. Of course, quitting smoking is essential in reducing the burden of lung cancer, but the ability to detect it early is equally as important.
Low Dose CT (LDCT) scan has emerged in recent years as an effective early detection tool. It works by identifying small nodules on the lung which may evolve into cancer. A large clinical trial showed that CT screening reduces lung cancer deaths by 20 percent. The dose from one LDCT scan is about a quarter of the radiation from a standard CT scan.
The obvious benefit of screening is that it can find lung cancer early, when it is most likely to respond to treatment. Other benefits may include detection of abnormalities like thyroid, pancreatic, or kidney nodules, as well as cardiac coronary disease.
Here are three things you need to know about LDCT scans:
Easy for both the patient and the provider. The exam is performed without the need for any preparation by the patient – some CT scans rely on dye given intravenously or orally, this one does not. In fact, the patient does not even need to change clothes.
Communication is key. Any kind of cancer screening should begin with a discussion of the risks and benefits. Ideally, there should be a shared decision-making office visit prior to the scan.
If the patient then decides to have the scan, a provider should discuss scan results the same day in order to alleviate unnecessary anxiety from a long wait for results. Patients receiving a scan should have rapid access to an expert if the scan shows an abnormality. Most importantly, patients should be encouraged to follow up annually.
Not right for everyone. Although screening for lung cancer is promising, there are risks. These may include false positives, which can lead to additional CT scans, and even biopsies and surgical procedures that may cause complications. It is also important to consider the additional exposure to radiation. While one scan is unlikely to have a significant impact, it is similar to the radiation in 15 chest X-rays.
Individuals are eligible for an LDCT if they meet ALL the criteria below:
- Aged 55 to 77
- Have smoked for at least 30 “pack” years (the number of packs smoked per day multiplied by the number of years smoking)
- Are either current smokers or quit within last the last 15 years
Newer drugs, better surgical techniques, and radiation delivery mechanisms continue to improve survival rates for lung cancer patients, and early detection from LDCT scan is a chance to make even more progress if enough eligible patients use it.
Rohit Kumar, MD, is an associate professor of the department of medicine at Fox Chase Cancer Center.