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A patient educational article from Radiology Associates

Did you know that Radiology Associates offers a chest imaging exam that can lower the risk of dying from lung cancer?

This asymptomatic 57 year old smoker had a low-dose lung cancer screening CT at one of our imaging centers.  A highly suspicious spiculated mass was detected in the right upper lobe (left image).  The lesion was then further evaluated with PET-CT (right image) to further characterize and was show to have abnormal metabolic activity consistent with a cancer.  Subsequent biopsy proved this to be a squamous cell carcinoma, a lung cancer almost always caused by smoking. 

Lung cancer is the second most common cancer in both men and women with about 224,210 new cases anticipated to be diagnosed in 2014 (source: cancer.org).  Although it is second in incidence, it is by far the leading cause of cancer death among both men and women. In fact, more people die each year from lung cancer than from colon, breast, and prostate cancers combined!  Despite medical advancements in surgery, radiotherapy, and chemotherapy the long-term survival of patients has remained low.

Since imaging has been shown over the years to sometimes detect small incidental lung cancers, the National Cancer Institute (NCI) funded the National Lung Cancer Screening Trial (NLST) in 2002 to determine if imaging could reduce mortality from lung cancer in high-risk individuals.  In 2011, the results from the NLST were published in the New England Journal of Medicine. In this clinical trial, more than 50,000 asymptomatic current and former smokers were studied.  The results demonstrated a 20% decrease in lung cancer mortality (death) in the patients screened with low-dose chest CT.  These results were later reviewed by the United States Preventative Services Task Force (USPSTF) and given a grade that supports annual screening with low-dose chest CT for high-risk individuals.

“The chest radiology community is very excited about this new data on decreasing lung cancer mortality in smokers,” explains Dr. Joseph Cox.  Dr. Cox is one of our Radiologists who is fellowship trained in Thoracic Imaging, which is a field specializing in imaging of the lungs and heart. He adds, “Our hope is that as more data becomes available, low-dose chest CT for lung cancer screening will be covered by insurance companies, just like mammography.”

Based on the promising results from the NLST, Radiology Associates Imaging has partnered with Halifax Health to offer a low-dose screening chest CT that meets all national guidelines.  If a patient meets the appropriate screening criteria, they can receive a low-dose chest CT scan for $99.

Summary Recommendations from the USPSTF:

Annual screening for lung cancer with low-dose CT in the following setting:

1. Adult aged 55 to 80 years
2. A 30 pack-year or greater smoking history
3. Currently smoke or have quit within the past 15 years

Note: Screening should be discontinued once the individual has not smoked for  15 years or develops a health problem that significantly limits life expectancy or the ability or willingness to have lung surgery.

What is a pack-year?

This is calculated by multiplying the number of packs per day by the number of years smoking.  For example, if someone has smoked 1 and a half packs of cigarettes per day for 30 years, they have a 45 pack-year history. (1.5 x 30 = 45 pack-years)

We will soon have more information on low-dose lung cancer screening CT on our website.  If you have any questions, you can reach Dr. Cox via email at jcox@radassociates.us or Dr. Gianini at jgianini@radassociates.us.

Here is a good resource for additional information on Lung Cancer and low-dose screening CT:  www.lungcancerscreeningsaveslives.org .