Coming Up – Screening For Lung Cancer

What is screening? 

What is cancer screening?

Simply put, screening is a test that is looking for early stages of a disease in people WITHOUT any symptoms.

In order for screening to “make sense” on the larger scale it has to look for a disease that can be cured or treated if found early.

When is screening recommended?

There are a lot of factors that need to be considered in regards to whether or not to screen for something and also whom to screen.

Not all screening is appropriate for everybody.

There is potential harm involved such as extensive follow up testing in false positive cases.

Additionally, there may be anxiety from the positive test results.

Sometimes, we might find a cancer that would normally have been progressing so slowly that the person would have died from other causes before even reaching end-stages of this cancer.

Screening is a big topic and I will talk more about it as we go along.

Today I want to mention something that is coming up!

And since we spoke about smoking yesterday it is right up the alley:

Screening for lung cancer!

Screening for lung cancer in smokers! 

Up until now there has been no screening method that has been proven to be successful when looking for early stages of lung cancer.

The US Preventive Services Task Force (USPSTF) has just released a draft recommendation (it is not finalized yet) for lung cancer screening in smokers.

You may check out the draft of this recommendation on their website by clicking here. The draft will be accessible until August 26, 2013 only.

Here some of their main points:

• Lung cancer is leading cause of cancer death in the USA
• 90% of people diagnosed with lung cancer will die from it as it is found too late
• the biggest risk factor for lung cancer is SMOKING
• 85% of lung cancer are caused by smoking
• the most important means to reduce your risk of developing lung cancer is to stop smoking and to avoid any exposure to tobacco

Screening for lung cancer in smokers: 

Low-dose CT scan for screening of lung cancer

How?

CT-scan (“CAT scan”) with lower dose of radiation

(low-dose CT, also LDCT) of the lung

Who is a candidate?

A person who is

• Between 55-79 years of age
• WITH a history of heavy smoking



Don't gamble with your health!

• AND is still a smoker or has stopped smoking within 15 years 

How often?

Once a year

What is defined as “heavy smoking”?

30 “pack years” and above is considered heavy

What is a “pack year”?

Smoking 1 pack of cigarettes per day (PPD) for 1 year = 1 “pack year”

So, 30 pack years are equivalent to the following:

• 1 pack per day for 30 years
• 2 packs per day for 15 years
• 3 packs per day for 10 years

What are some of the harms of screening?

• Radiation exposure
• False positive test results that may lead to
• More testing
• Anxiety
• worry

As I mentioned this is currently still a draft but probably coming up as an official USPSTF recommendation soon.

If you fulfill the criteria for screening, discuss it with your doctor whether or not you are a candidate and whether or not you want to go forward with this.

Stop smoking TODAY!

If you still smoke: STOP (check yesterday’s post)!

Nothing good comes from smoking! 

Do I HAVE to go for the screening, if I don't want to?

Nobody can force you to do anything. You can make your decision. Just think through all the options and discuss them with your doctor and people you trust.

If you have many medical problems and already feel burdened by all the medical treatment that you are undergoing you may want to think about what the consequence of a positive test result would be for you. 

Would you want treatment?

Would you consider further testing, surgery, or chemotherapy?

If not, you may not want to do the screening test to begin with.

Sometimes it is better not to know.

Have a wonderful rest of your day.

Be well,

Dr. B

PS: This is based on a systematic review published in the Annals if Internal Medicine on July 30, 2013. Click here for link to article.