Lung Cancer Screening

Low Dose CT Lung Cancer Screening
Dr. George W. Privett, Jr.

In honor of Lung Cancer Awareness Month, we should be reminded that Kentuckians have the highest rate of death from lung cancer in the United States. Most lung cancers cause no symptoms until they are too large to be successfully treated.

Lung Cancer is a dreaded diagnosis, particularly when it is discovered after it has already spread throughout the body. What can you do to lower your risk of early death from Lung Cancer? There are two things: 1. STOP SMOKING! and 2. Get a screening test for early detection.

Discovering a screening test that would effectively diagnose this disease before it spreads and would make a cure possible has not been easy. Chest X-rays and sputum analysis for malignant cell have been tried in the past without success.

Fortunately, the CT Scan became available. The CT (or Computed Tomography) scanner takes images of the lungs by spinning an X-ray tube around a patient lying on a bed. By using a powerful computer program, detailed images of the lung are obtained that can detect lung tumors as small as 2 mm. No injections or dyes are needed and the test takes less than 10 minutes. In addition and at no extra charge, other structures in the chest such as the aorta, spine, lymph nodes, heart and ribs are imaged.

We have been providing Low Dose Screening Lung CT for 10 years. However, it was only recently that a large study confirmed what we had suspected – a CT Screening is very effective at reducing deaths in high risk patients by detecting lung cancers early when they are still curable. (As an aside, Screening Lung CT is much more effective than Screening Mammograms and Screening PSA for prostate cancer.)

What is High Risk? High Risk is defined in patients are those who are 55 to 74 years of age who have smoked at least one pack of cigarettes per day for 30 years (or two packs per day for 15 years, etc.). If a tumor is found, then the patient will need additional tests and possibly a biopsy to determine if it is a cancer or something benign.

Because a spiral CT scan is so detailed, it is possible that something will show up on the exam that is not cancer (false positive) and additional necessary testing may be costly and lead to side-effects. There is also slight risk due to radiation exposure; however, modern screening is performed with low dose techniques to minimize the exposure.

Currently Anthem covers this Screening Lung CT, and because of the Affordable Care Act (Obama Care) all other commercial carriers must cover it by January 1, 2015. Medicare will decide if it is going to cover the Screening in November 2014. Low Dose CT may cost as much as $500 in some hospital based centers. For patients without insurance, the current cash price at Lexington Diagnostic Center is $169, and this includes the radiologist charge.

Remember, most lung cancer can be successfully treated if it is found early. If you are at high risk for lung cancer you should consider Low Dose CT Lung Screening, especially if you meet the following criteria:
• Age 55 to 74
• Current or past smoker
• 30 pack-year history of smoking
And no matter what your risk is…..If you are a smoker, stop!