Low-Dose CT Screening For Early Detection of Lung Cancer in Smokers
Medicare will now provide coverage for lung cancer screening that uses a new computerized tomography (CT) procedure. This procedure exposes patients to lower doses of radiation than previously used CT scans.
To qualify for coverage, patients must be between 55 and 77 years old, have a smoking history of at least 30 “pack-years,” and either still smoke or have quit within the past 15 years. In addition, the patient must first have a “consulting and share” decision-making visit with a physician to discuss the potential risks and benefits of the screening. This tool can help determine your lung cancer risk and eligibility: http://www.shouldiscreen.com/lung-cancer-risk-calculator.
Insurance companies are realizing the benefits of early lung cancer detection: earlier detection allows for closer monitoring and/or earlier treatment, which can extend life. Patients, however, should be aware of the potential risks of these tests. The results could indicate that cancer is present when it is not (a “false positive” result), leading to unnecessary follow-up exams and possibly treatments. This has been a major criticism of the CT scan for lung cancer screening and is the focus of a recent article in the New York Times. Two methods can now help decrease this false positive rate. First, a new scoring system for CT scans can reduce the false positive rate two-fold. As of March 2015, the American College of Radiology started implementing this scoring system. Second, if the CT scan is positive, the common follow-up test – a bronchoscopy (relatively safe but limited by its sensitivity) – can be made more reliable with a new add-on test. Studies have shown that adding a genomic test of bronchial epithelial cells to the standard bronchoscopy improves its ability to diagnose cancer. This combined assay is awaiting approval from regulatory agencies. GlobalCures encourages heavy smokers or former heavy smokers to talk with their doctor about getting annual low-dose CT screening. As part of our effort to help individuals who are at risk of getting cancer and would like to improve their health, we offer the following suggestions:
Work toward the difficult but important goal of quitting smoking. As noted in the American Cancer Society’s Guide to Quitting Smoking, “smoking cessation represents the single most important step that smokers can take to enhance the length and quality of their lives.”
Improve your diet. William (Bill) Lands argued that the careful use of dietary fats can improve life and prevent disease. You may want to take around 2 grams of good quality fish oil each day. The long-chain polyunsaturated fatty acids in fish oil are thought to be important for blocking the formation of arachidonic acid and its role in chronic inflammation and cancer. We also like Michael Pollan’s straightforward advice to “Eat food. Not too much. Mostly plants.”
DISCLAIMER: THIS BLOG CONTAINS INFORMATION BUT NOT MEDICAL ADVICE. IF YOU FIND THIS INFORMATION RELEVANT, YOU SHOULD DISCUSS IT WITH YOUR DOCTOR.
This blog is the first of a three-part series that focuses on the prevention, detection and treatment of lung cancer.