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Catching lung cancer early through screening saves lives

lung cancer screening chart

This is one of a series of articles focusing on lung cancer.

Lung cancer screening saves lives —  and could save more, if more people submitted to the testing.

Of the lung cancers that are discovered through a lung cancer screening program, 80% are at an early stage — and most of those can be cured with surgery.

Compare that with the general population of people who discover they have lung cancer when they develop symptoms or have a chest X-ray for some other reason. Of those lung cancers, only about 15 percent are at an early, curable stage.

HealthLink on Air logo(Hear Upstate surgeon Jason Wallen, MD, discuss lung cancer screening, including who should get screened and how the process works, in this "HealthLink on Air" podcast.)

“We can save tens of thousands of lives, provided they get the screening and continue to get the screening,” says Leslie Kohman, MD, the medical director for the lung cancer screening program at Upstate. She says studies have proven how well screening works, using low-dose computed tomography, ror CT scans. Men whose cancers were discovered through screening had a 26% lower mortality rate than men who were not screened. The mortality rate for women is even better.

patient getting a scan Low-dose CT scans help screen patients for lung cancer.

The ability to screen people for lung cancer has been available for about 10 years, and today the American Cancer Society recommends screenings for certain smokers and former smokers at high risk for lung cancer.

Just 2% of those eligible for lung cancer screening undergo the test, Kohman says. That’s two people out of 100.

And that’s the big reason more lung cancers aren’t caught early, she says. Those other 98 people are either unaware of screening, or they’re afraid — of radiation exposure, of the cost, of what happens if cancer is found.

Kohman addresses those fears:

  • The lung cancer screening scans use lower doses of radiation than are used for standard CT scans. “It’s like the amount of radiation you would get from the atmosphere if you flew in an airplane across the country,” she says.
  • Lung cancer screening requires a referral from a physician, but for eligible patients, it’s paid for by most health insurers, including Medicaid and Medicare.
  • If the radiologist detects something unusual in the lung scan, a biopsy may be required. Kohman explains that an experienced lung cancer screening program, such as Upstate’s, has a strong record of only recommending biopsies when they are necessary.

Upstate is a certified center of excellence for lung cancer screening and has offered the test for the last decade.

Do you have symptoms?

Lung cancer screening is for people at high risk for developing lung cancer who do not have symptoms. Someone who has symptoms – including persistent cough, hoarseness, shortness of breath, coughing up blood, unexplained weight loss, or chest pain that worsens when you take a deep breath – may need a diagnostic scan, which is similar. Kohman urges people to bring symptoms to the attention of their primary care doctor.

A point to consider

“We don’t completely understand the biology of this, but we know there are distinct differences in the biology of lung cancer in women versus men,” says Kohman. Lung cancer in men is probably present for about four years before it will show up on a scan; for women, it’s about six years.

Cancer Care magazine fall 2019 issue coverThis article appears in the fall 2019 issue of Cancer Care magazine.