CT Lung Cancer Screening: FAQ

Lung cancer is an uncontrolled growth of abnormal cells in the lungs. These abnormal cells often grow together in clumps called tumors. The tumors destroy and replace normal, healthy tissue and interfere with organ function.

Lung cancer is the leading cause of cancer deaths in the United States. Every year, lung cancer kills more people than breast cancer, prostate cancer and colon cancer combined. Today, substantially more women die from lung cancer that from breast cancer. It is firmly established that the overwhelming majority of lung cancers are caused by smoking cigarettes. Other important risk factors are exposure to asbestos fibers, natural radon gas or air pollution. Unfortunately, lung cancer is usually detected late in the course of the disease. When the first symptoms occur, such as a cough, the cancer has often already grown to an advanced stage and can rarely be cured (over 85% five year mortality).

The main risk factor for getting lung cancer is exposure to cigarette smoke. There is no “safe” number of cigarettes—no “lower limit” on the number you can smoke each day and not be at risk of getting lung cancer. It is known that smoking more than 20 cigarettes (a standard pack) per day for 10 years substantially increases your risk of developing lung cancer. It is currently debated whether inhaling second-hand smoke from others actually puts you at a higher risk for developing lung cancer.

 

The other major risk factor is asbestos exposure. Asbestos is a noncombustible, fibrous material that was once used very commonly in fireproofing, electrical insulation, building materials, brake linings, and chemical filters. Most exposure was work-related, though you could have encountered asbestos while making repairs or renovations to an older home. If you were exposed to asbestos fibers, you have an increased risk of getting lung cancer. Like most cancers, lung cancer tends to occur later in life. Lung cancer is rarely observed in people under the age of 45-50 years.

The best way to reduce your risk of getting lung cancer is to stop smoking. Besides quitting smoking, participation in a lung cancer early detection program would be your best bet.
You do not need a physician referral to schedule a CT Lung screening scan. Because this is a screening procedure, please be aware that this exam is not covered by Medicare or group health insurance at this time (see next question). Payment must be made at the time of the exam. Urgent results will be phoned immediately to your physician, otherwise the results of your exam will be mailed you and your physician in a few days.
At this time most insurance companies do not pay for screening chest CT exams in asymptomatic patients, be they smokers or non-smokers. Insurance companies will reimburse the expense for medically necessary tests. If you have a clear indication for a chest CT scan such as a chronic, unexplained cough or emphysema, then your physician may order you to have a chest CT to evaluate your condition. If you believe that your medical insurance may pay for your chest CT exam, you should check with your physician prior to scheduling your exam. Otherwise, Advanced Body Scan of Newport requires payment in full at the time of the examination.
After a brief medical history is taken, you will be positioned by a technologist on the CT table. No preparation is required. You will be asked to hold your breath for about 20 seconds and then your exam will be over. There is no injection of I.V. contrast involved. The entire exam takes less than a minute
First, congratulations on having a negative test. This is the $64,000 question. At this time no one knows. Unlike colon cancer and breast cancer, which are slow growing tumors so that we doctor’s can recommend repeat sigmoidoscopy (or colonoscopy) every 5 to 10 years for early colon cancer detection and mammograms every 1 to 2 years for breast cancer detection, cancers of the lung are more aggressive and faster growing tumors. This means that your scan may turn positive as soon as three to six months after your first scan. In the absence of definitive recommendations, we are recommending that anyone at risk for lung cancer should undergo repeat CT chest scans at least once yearly as a minimum lung cancer screening protocol. Hopefully, we will be able to give you a better answer in the not too distant future.
Unfortunately, the medical community in the United States still considers lung cancer screening controversial and you will find physicians on both sides of the debate. Lung cancer screening with annual chest X-rays was the standard of care in the United States up until the 1970′s. Then the results of research studies on the effectiveness of screening for lung cancer with chest X-ray found that although it was possible to discover lung cancers earlier with chest X-ray, the cancers found were already too large and therefore, too advanced to treat and so these screening programs utilizing conventional chest X-ray did not improve the mortality of the disease. Because of these studies, lung cancer screening programs were abandoned in the 1970′s and resources were diverted from early detection programs to prevention programs. Only recently that it has been shown that CT technology, which can detect growths much smaller than what can be seen with conventional chest X-ray, is effective in finding lung cancers early when they are more likely to be at a curable stage. The National Cancer Institute is currently enrolling 50,000 participants between the ages of 55 to 74 in the National Lung Screening Trial. The American Cancer Society has not yet taken a position on lung cancer screening with CT technology. Advanced Body Scan of Newport has decided to let the patient decide whether or not he (she) should have a screening chest CT scan as it may take many years before this debate is finally settled.
We know that that from 25 to 50 percent of individuals undergoing screening CT lung scans will have some abnormality (such as small nodules or abnormal clusters of cells). The majority of the time, these abnormal findings are not lung cancer. However, these abnormal findings –old smoking scars, areas of inflammation, other noncancerous conditions– can mimic lung cancer on CT scan and will require additional testing. If small lesions are found in a person undergoing CT lung cancer screening; however, we will ask that person to return for repeat examinations after several months. If their lesion is larger on a later examination, this growth may indicate malignancy (cancer). Again, in most cases, no cancer is found. But by keeping track of any changes in the lesions, we can be more certain that a cancer will be detected early if it is present. These additional tests may cause anxiety or may lead to biopsy or surgery.

 

In addition, there is the possibility that the tumor found with the screening CT exam may be very small and would never grown to become life threatening. Because some things remain unknowable, clinical trials are underway and the final answer remains in the future.

 

 

More on Lung Cancer

National Public Radio report on CT Lung Cancer Screening

CT Lung Cancer Screening Frequently Asked Questions