Early Lung Cancer Screening Program
Hoag Family Cancer Institute is committed to the prevention and early detection of lung cancer. One of the best ways to prevent lung cancer is to never start smoking, or if you are smoking – stop. Hoag offers an extensive smoking cessation program and many resources to help individuals to stop smoking. Learn more about Hoag’s Smoking Cessation Program.
National Lung Cancer Screening Study Shows Early Detection Saves Lives
In 2011, the National Cancer Institute released results of its National Lung Screening Trial (NLST), which showed that low-dose CT scans reduced mortality from lung cancer by 20 percent in patients between the ages of 55-77, with greater than a 30 pack-year smoking history. The study, which was conducted between 2002 and 2009, randomized 53,456 smokers or former smokers to screening by either a traditional chest X-ray or a low-radiation dose spiral CT scan, once a year for three consecutive years.
Hoag Family Cancer Institute’s Lung Cancer Screening Recommendations
Hoag Family Cancer Institute aligns with numerous national medical societies and organizations, and recommends annual low dose chest CT screening in patients 55-80 years old with a history of heavy smoking (greater than 30 pack-year*).
Annual screening is currently recommended for this population by the American Cancer Society, National Comprehensive Cancer Network, American College of Chest Physicians, American Thoracic Society, American Society of Clinical Oncologists, American Association of Thoracic Surgeons, the American Lung Association, and the U.S. Preventive Services Task Force.
Some of the organizations also suggest screening patients 50 years or older with a 20 pack year* smoking history who also have an additional risk factor such as:
- Family history of lung cancer
- Prior history of smoking related malignancy (head/neck, lung, esophageal), or lymphoma
- Radon exposure
- Certain occupational exposures (asbestos, arsenic, cadmium, chromium, nickel, diesel fumes, beryllium)
- History of COPD or Pulmonary Fibrosis
The above recommendations should take into account issues such as co-existing illnesses and life expectancy, and should be discussed with your physician. Hoag encourages you to use this Shared Decision-Making brochure in your conversation.
*Pack-year refers to number of packs smoked per day, multiplied by number of years smoked.
Hoag Early Lung Cancer Screening Program
Hoag’s Lung Cancer Screening Program is recommended for both current and former smokers, following the recommendations listed above. Read more about Hoag’s Lung Cancer Screening Program.
Hoag’s Lung Cancer Screening Program is through physician referral only. Medicare and other insurance carriers will reimburse the cost of lung cancer screening for patients who meet certain criteria. This criteria includes: being between the ages of 55-80, having smoked at least the equivalent of one pack of cigarettes per day for 30 years. Medicare also requires that you and your physician discuss low-dose CT scan screening, and if it is right for you. Feel free to read through our Shared Decision-Making brochure, to help lead the conversation.
Hoag Lung Screening Service – Is a Lung Screening Right for You?
Hoag also offers a service focused on the discussion and assessment if lung cancer screening is right for you. This appointment with a nurse practitioner reviews medical history, lung health history, among other things, to complete this Shared Decision Making step. Your physician may refer you to this service, or you can refer yourself. To schedule a Shared Decision Making appointment through Hoag’s Lung Screening Service, please call 888-835-8772.
For More Information
To learn more about Hoag Lung Cancer Screening Program, please call Lung Cancer Nurse Navigator Lilian Reed, R.N. at 949-764-6889.
Lung Cancer Support Group
Frequently Asked Questions about Lung Cancer
Q: Why is the death rate from lung cancer so high?
A: Since early lung cancers usually do not exhibit symptoms, by the time symptoms occur, the cancer has often spread (metastasized). The treatment success for metastatic lung cancer can be limited. However, patients with stage 1 lung cancers, or early small lung cancers, detected before spreading, have much better survival rates.
Q: What is the difference between a chest X-ray and a low dose CT scan?
A: A chest X-ray is an X-ray picture taken of the chest, one image from the back and one from the side. The X-rays form an image of the chest including the lungs, but other structures like the heart and spine, may obscure parts of the lungs where a cancer might be. Chest X-rays have not been shown to be useful for the early detection of lung cancer.
CT imaging utilizes a doughnut-shaped camera (scanner). The CT scanner takes several cross sectional images of the chest. CT imaging results in a more complete picture, it’s as if your body is loaf of bread, and we’re taking one slice of bread at a time and looking at the face of it, and then we continue looking at the face of each slice through the whole loaf.
Q: Why are the CT scans called “low dose?”
A: When screening healthy smokers or former smokers for lung cancer, only the lungs need to be viewed. As a result, the radiation administered during the scan can be lowered to about one-sixth of what is given during a conventional CT scan.
Q: Does this new study mean that smokers do not need to stop smoking if they get screened regularly?
A: No. The best way to prevent lung cancer is to not smoke, and if you are currently smoking, the best thing to do is quit.
Q: If a smoker stops smoking, will that lessen his/her risk for cancer?
A: A smoker who stops smoking will significantly reduce his/her risk of lung cancer. However, the risk of cancer will not decrease to the low risk of someone who has never smoked.
Q: The screening is recommended for heavy smokers or former smokers, what is considered a heavy smoker?
A: The amount someone has smoked is quantified in pack-years. It is the number of years someone smoked multiplied by the number of packs smoked per day. If someone smokes one pack a day for 10 years, they have a ten pack-year smoking history. If they smoke 2 packs a day for 10 years, they have a 20 pack-year smoking history. There is no exact point where someone is considered a heavy smoker. For the purposes of the National Lung Screening Trial, a 30 pack-year smoking history was considered a heavy smoker, however, it is best to consult with your physician on where you would be classified.
Q: What happens during the lung cancer early detection screening?
A: First, a physician referral is required. During the imaging test, you will need to lie down on the CT table and hold your breath for about 10 – 15 seconds, while the images are taken. Your results will be provided to your referring physician, who will review them with you during a follow-up consultation.
Many individuals will have a nodule from an old infection, or a scar, which can be difficult to distinguish from a very early cancer. In these cases, the patient will be referred to a pulmonologist for consultation and will need to come back for a follow-up scan in 6 -12 months (based on physician recommendation) to make sure the nodule isn’t growing.