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August 8, 2013
Doretta Royer 315 464-4833

Lung cancer expert urges high-risk smokers and ex-smokers to get screened for lung cancer

SYRACUSE, N.Y. The new recommendation for an annual low-dose CT scan for high risk smokers and ex-smokers to detect early lung cancer, announced last week by the U.S. Preventive Services Task Force (USPSTF), is expected to save at least 20,000 lives each year and will trigger Medicare and insurance coverage., experts say.

Upstate Medical University lung cancer specialist Leslie Kohman, M.D., is encouraging those at risk for the disease not to wait for the new standards to take effect but to get screened now as it may be 12 to 18 months before most insurance companies will cover the cost.

“The new recommendations are a significant step forward in saving lives, since to save a life you need to catch the disease in its earliest stages,” said Kohman, medical director for the Upstate Cancer Center at Upstate Medical University. “So we are encouraging those at risk not to wait, but to stop smoking and be screened as soon as possible.” Kohman also emphasizes that stopping smoking will save even more lives and is the most important strategy in reducing deaths from lung cancer. “There is no need to wait for this,” said Kohman.

Kohman served as Upstate’s lead investigator when, in 2001, Upstate was one of 12 sites in New York state to participate in the New York Early Lung Cancer Action screening study. Overall findings from the study showed significant benefit of low dose scans in detecting early lung cancers. The findings also served as the impetus for the National Lung Cancer Screening study which resulted in the changed guidelines for screening for lung cancer.

In issuing its new draft recommendations, the USPSTF gave its second highest approval rating—B—for CT screening for lung cancer for those at high risk, a move that if approved in final form, will trigger Medicare and insurance coverage and bring about a dramatic drop in the leading cause of cancer deaths. For comparison, Kohman says that mammogram screenings also carry a “B” rating, a strong indicator that the new guidelines for lung cancer screening will become reality. Under the Affordable Care Act, all recommendations rated as “A” or “B” must be covered by all insurers with no co-pay for the patient.

Current standards for lung cancer screening are targeted to high-risk smokers and ex-smokers between the ages of 55 and 74 who smoked at least the equivalent of a pack of cigarettes a day for 30 years (or two packs a day for 15 years, ½ pack a day for 60 years etc). Individuals who no longer smoke can be screened, but they must have quit smoking within the last 15 years to be eligible.

The new screening recommendations have expanded the indications up to age 79.

According to Laurie Fenton Ambrose, president and CEO of Lung Cancer Alliance (LCA), the most important next steps are to help educate the public about risk and to direct them to responsible screening. LCA, a national non-profit based in Washington, D.C., has advocated for better lung cancer screening protocols since the organization’s inception in 1995. It launched its National Framework for Excellence in Lung Cancer Screening and Continuum of Care in 2011. The guidelines ensure responsible screening practices across the nation. Today approximately 100 centers, including the lung cancer screening program at Upstate Medical University, have adopted these principles or have been identified as following best practice guidelines in lung cancer care.

“Upstate Medical University is the only facility in Central New York to be listed by the Lung Cancer Alliance as among the nation’s ‘experienced sites’ in offering a comprehensive Lung Cancer Screening Program,” said Kohman. “Participants are individually counseled as to the relative risks and benefits of the screening process.”

In addition to the low dose CT scan with professional interpretation by an expert chest radiologist, Upstate offers those screened with onsite smoking cessation counseling at the time of the scan with follow up counseling for up to one year. This counseling, as well as individualized phone calls and follow up as well as timely evaluation of any abnormalities, is included in the greatly discounted $235 screening cost.

Launched in the fall of 2012, Upstate’s Lung Cancer Screening Program is sponsored by the Upstate Cancer Center and Upstate Radiology.

Upstate will immediately increase the upper age limit for individuals to be screened to 79, as long as they meet the other high-risk criteria, including those who have smoked at least a pack of cigarettes a day for 30 years or equivalent. Ex-smokers must have quit smoking within the last 15 years to be eligible, since the benefit decreases with reduced risk after 15 years of cessation.

Upstate’s Lung Cancer Screening Program is unique due to its extensive experience with low-dose CT scans in the use of lung cancer detection. “Our state-of-the-art CT scanner allows for personalized radiation at the lowest effective dose,” said Kohman.

Upstate program has screened 55 patients in its first 10 months, compared to the national average of 47 patients annually. We’re here to save lives,” said Kohman.

For more information about the Lung Cancer Screening Program, contact Linda Veit, MPH, at 464-6303. To make an appointment for a screening, call Upstate Connect at 315-464-8668.

Caption: Leslie Kohman, MD, is director of the Upstate Cancer Center and of Upstate’s Lung Cancer Screening Program.

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