More people die from lung cancer than from breast, prostate, and colon cancers COMBINED. For most patients, lung cancer is already at an advanced stage when first detected and cannot be cured. Low dose CT screening can detect lung cancer at earlier stages in high risk patients and decrease risk of death from lung cancer by 20%.
- Adults age 55 or greater
- Tobacco use > 30 pack year history (1 pack per day or more for at least 30 years)
- adults age 50 or greater
- tobacco use > 20 pack year history
- additional risk factor such as history of cancer, family history of lung cancer, occupational exposure to carcinogens (ie. asbestos, diesel fumes), radon exposure, COPD, or pulmonary fibrosis
- The National Lung Screening Trial (NLST) studied over 50,000 patients at high risk for lung cancer across 33 U.S. medical centers.
- Patients were randomized to lung cancer screening with yearly low dose CT versus chest X-ray for 2 years.
- CT screening decreased the rate of death from lung cancer by 20% and the rate of death from any cause by 6.7%.
- Many questions remain unanswered, but there will not be a larger or better conducted study on lung cancer screening in the foreseeable future.
- As of 2012, the National Comprehensive Cancer Network (NCCN) recommends lung cancer screening for high risk patients.
- Almost 25% of high risk patients have abnormalities on screening CT.
- Only 3-4% of these abnormalities are due to lung cancer.
- Many patients undergo unnecessary tests and invasive procedures for abnormalities that are not due to lung cancer.
- Low dose CT screening for lung cancer is NOT yet covered by most insurance companies. CPMC offers low dose screening CTs for $400 which includes the scan and interpretation by board-certified Radiologist.
- Low dose CT uses 4-5x less radiation than a standard CT and no IV is required.
- Follow-up of abnormalities detected on screening CT IS covered by most insurance companies if medically indicated.