In a major policy change, government advisers are recommending annual CT scans for certain smokers and former smokers. The recommendations on routine lung cancer screening apply to adults who have no signs or symptoms but who are at high risk for developing the disease because they are current or former smokers.
“The Task Force recommendation in favor of CT scans for lung cancer screening is a landmark moment in the fight against lung cancer, the leading cause of cancer deaths among men and women in the United States. By screening high risk people with low radiation exposure chest CT scans, death from lung cancer can be significantly reduced, and done so cost effectively. The Task Force recommendation likely will lead to widespread insurance coverage for this important screening test,” says Ella Kazerooni, M.D., M.S., professor of radiology and director of cardiothoracic radiology.
The new recommendations:
The new final recommendations calls for annual screening in adults who:
• are 55 through 80 years old, and
• have a history of heavy smoking, and
• are either current smokers or who have quit within the past 15 years.
Heavy smoking means a smoking history of 30 “pack years” or more. A “pack year” is smoking an average of 1 pack of cigarettes per day for 1 year. For example, a person could have a 30 pack-year history by smoking 1 pack a day for 30 years or 2 packs a day for 15 years.
The recommendations also say that screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. Read a public-friendly summary of the entire recommendation here.
Unfortunately, about 90% of the people who have lung cancer die from the disease, in part because it is often not found until the cancer is at an advanced stage. The goal for making it routine to get low-dose CT scans for lung cancer screening is to find the cancer earlier, when treatment can more likely result in a cure.
According to Douglas Arenberg, M.D., associate professor of internal medicine and director of the U-M Lung Cancer Screening Program, “This is a very important announcement, and a big advance for our field but it should be done right, and by experts. Screening carries risks, and these risks can be minimized by seeking medical experts with significant experience in managing indeterminate pulmonary nodules. Our multidisciplinary team has worked together in this field for more than 15 years. We have used a proven means of monitoring patients with lung nodules that minimizes unnecessary invasive procedures when the risk of cancer is very low.”
The Task Force reviewed a number of studies on the potential benefits and harms of lung cancer screening, including results from the National Lung Screening Trial, a very large and important study of more than 50,000 people. The Task Force found that low-dose CT scans more accurately identify early stage cancer than other screening tests. They also found that many lung cancer deaths can be prevented by screening high-risk people every year.
“After spending 20 years researching better ways to treat people with lung cancer, I am convinced that prevention and early detection are the best ways to have a major impact on the high mortality associated with the disease. The recent data on CT screening for lung cancer promises to reduce the number of deaths from lung cancer; all high-risk smokers should be encouraged to seek counseling and potential screening through comprehensive screening programs, such as the one offered at the University of Michigan,” says Gregory Kalemkerian, M.D., professor of internal medicine and director of the U-M Multidisciplinary Lung Cancer Clinic.
Where to go for more information
U-M Comprehensive Cancer Center: Cancer AnswerLine™ call 800-865-1225
U-M Comprehensive Cancer Center Lung Cancer Screening Guide
Dr. Kalemkerian talks about lung cancer on YouTube: What Everyone Needs to Know about Lung Cancer
Dr. Kazerooni and Dr. Arenberg talk about lung cancer screening, including risks and benefits, on YouTube: Lung Cancer Screening
U-M’s Lung Cancer Screening Clinic is a special clinic designed to meet the recommendation from the National Comprehensive Cancer Network to screen high risk patients. Recent research has shown that people aged 55-75 who currently smoke, or have smoked at least 30 pack years (1 pack of cigarettes a day for 30 years) can reduce their chances of dying from lung cancer by undergoing a process of screening. As with many cancers, the earlier it is detected, the better the chance for success.
The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.