Thursday, March 4

Who should consider yearly screenings for America’s most deadly cancer? – WTOP

Diagnostic screenings for those considered at-risk for lung cancer can save lives, but very few people get them done.

Diagnostic screenings for those considered at-risk for lung cancer can save lives, but very few people get them done.

Lung cancer is the deadliest cancer in the U.S., killing more people each year than breast, colon and prostate cancers combined.

“We know we don’t have enough patients screened at this point. We’re reaching, in most states, probably 4% of eligible patients; some states are up to 10% or 12%,” said Dr. Debra S. Dyer, of the American College of Radiology, or ACR.

Promoting yearly screening with low-dose lung CT scans for people who need testing, Dyer believes one challenge involves the formula involved for evaluating who needs it.

ct screening
This is an image of a low dose CT lung screening. (Courtesy American College of Radiology)

“Eligibility requirements are not as easy, as say for mammography or colon cancer screening. Those are based on gender or age,” she said.

“For lung cancer screening, right now, you have to have been a smoker, and you have to have that minimal history and be at least age 55.”

It’s the smoking history part that can be tricky.

Heavy smoking means a smoking history of 30 pack-years or more. Parsing pack-years involves a formula. A person could have a 30 pack-year history by smoking an average of one pack a day for 30 years or two packs a day for 15 years. Screening is not recommended for people who quit smoking 15 or more years ago.

According to the Centers for Disease Control and Prevention, people who should get screened:

  • Have a history of heavy smoking.
  • Smoke now or have quit within the past 15 years.
  • Are between 55 and 80 years old.

“The low dose CT that we use now, with our advanced scanners, we can see exquisite detail in the lungs, and we can find these really small, early-stage cancers,” Dyer said.

And that can save lives.

For people meeting the criteria, commercial insurance covers lung cancer screening as a preventive service.

The American Lung Association notes that D.C., Virginia and Maryland are among the 38 Medicaid fee-for-service programs covering lung cancer screening with low-dose CT scans as of September 2020.

Also, at-risk people who are 55 to 77 years old are eligible for the screening under Medicare.

If you’re considering lung cancer screening, you can consult this decision aid from the Agency for Healthcare Research and Quality to help prepare you to talk with your doctor.

The ACR website can help you find nearby accredited facilities for screening. Under the “Designation” drop-down menu, select “Lung Cancer Screening Center.” There are two in D.C. and several more throughout Virginia and Maryland.

According to the CDC, the best way to reduce your risk of lung cancer is not to smoke and avoid secondhand smoke.

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