Don’t wait, get screened early for lung cancer

LUNG CANCER is the leading cancer killer in the United States even though it is highly curable if detected at an early stage. Yet less than 2 percent of the at least 9 million Americans who are eligible for lung cancer screening are getting tested for the disease. And, according to a study reported last month, the benefits of lung cancer screening are even greater than the medical community realized, reducing mortality by 26 percent for high-risk men and up to 61 percent for high-risk women.

The low lung cancer screening rates are in stark contrast to the over 70 percent of women eligible for breast cancer screening who have undergone a mammogram within the past two years. The medical community agrees early detection through screening has contributed to the significant decline in breast cancer death rates since the late 1980s.  While the overall death rate from cancer in the United States has declined over the last two decades thanks to advances in primary prevention, early detection, and treatment, work must now be done by medical centers across the country to raise the low screening rates for those at high risk of developing lung cancer.

The American Lung Association recommends high-risk individuals get screened annually. Those considered at “high-risk” for developing lung cancer are people 55-80 years of age who smoked one pack of cigarettes a day for 30 years or two packs a day for 15 years and who are a current smoker or someone who quit within the last 15 years.  Screening is done with a low-dose CT scan, which uses approximately 10 times less radiation than traditional tests, to scan the body and create detailed pictures of the lungs. Clinicians then review the images to look for signs of lung cancer.

Lung cancer screening is done before a high-risk individual displays any symptoms of cancer, since lung cancer patients often exhibit these symptoms only after the cancer has progressed to an advanced stage. While patients diagnosed with Stage IV lung cancer have a five-year survival rate of less than 1 percent, patients diagnosed with screen-detected Stage I lung cancer can have over a 90 percent five-year survival rate.

Since opening the Rescue Lung, Rescue Life lung cancer screening program at Lahey Hospital & Medical Center in Burlington,  we have screened over 5,000 individuals at high risk and detected 200 lung cancers, 85 percent of which have been early stage (Stage I or Stage II). We estimate 70 percent of our patients at high-risk have undergone lung cancer screening – far higher than the nation-wide 2 percent rate. While we’re at an advantage as one of the oldest and largest clinical lung screening programs in the country, we believe hospitals around the country can achieve comparable early detection rates by adopting similar protocols for screening high-risk patients. To accelerate this process, we have made all our program materials available at no charge and have distributed these documents to over 700 screening centers worldwide.

While educating hospitals and caregivers on the benefits of early screening is key to increasing survivability, it’s critical that policymakers acknowledge and embrace the benefits as well. Many of us in the medical community are encouraging the Center for Medicare & Medicaid Services to expand coverage to another high-risk cohort: current or former smokers over 50 who have smoked on average of at least one pack of cigarettes per day for 20 years and who have another risk factor for lung cancer (such as asbestos exposure or chronic obstructive pulmonary disease).

This November, let Lung Cancer Awareness Month serve as a time of renewed focus on the benefits of early screening. I encourage anyone wondering about their chance of developing the disease to speak to their doctor to determine whether they’re considered high-risk and if screening is right for them. The success of breast cancer awareness campaigns shows that it’s possible to grow awareness for a disease, empower individuals to take a more active role in their healthcare and, ultimately, save lives. It’s time to do the same for those who are at high-risk of developing lung cancer.

For additional information about lung cancer screening and access to resources, contact the American Lung Association by phone by dialing 1-800-LUNGUSA or visiting www.lung.org.

 By Dr. Andrea McKee is the chair of radiation oncology at Lahey Hospital & Medical Center and spokesperson for the American Lung Association.