Screening may detect lung cancer at its earliest stages

PITTSBURGH — A lung cancer screening method that is recommended for long-term smokers, whether they have quit or not, promises to detect cancer at its earliest and most curable stages. However, most insurance does not cover the cost, and participation has been limited.

To raise awareness of the screening and its potential, West Penn Hospital is now offering low-dose computer tomography screening for free, supported by a grant from Highmark, a national health and wellness company. High-risk patients ages 55 to 74 are eligible for the program and must have a history of smoking a pack a day for 30 years or two packs a day for 15 years. They must either be current smokers or have quit within the past 15 years.

This can be a life-saving opportunity, said Lana Schumacher, a thoracic surgical oncologist and co-director at the Esophageal and Thoracic Institute at Allegheny Health Network. Lung cancer is the third most common cancer in the U.S. and the leading cause of cancer death.

“Some patients are too worried to get a scan, worried we’ll find something,” Schumacher said, adding that patients should know that even if cancer is found, if it’s in an early stage before symptoms appear, “the survival rate goes up dramatically, to 85-90 percent over five years. Once a person shows symptoms, it’s a five-year survival rate of 15 percent.”

Looking for nodules

The benefits were shown in 2011 by the National Lung Screening Trial. Participants who received the low-dose CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays. Annual scans are recommended by the U.S. Preventative Services Task Force.

The West Penn screening is part of a pilot project for the Allegheny Health Network, which plans to implement it throughout the network.

The CT test does not require any preparation or injections. Patients can make an appointment by calling a phone line. A lung cancer nurse navigator will contact them and lead them through the screening process and explain the implications of results.

“In the future we hope insurance companies will reimburse this,” Schumacher said. The radiation exposure in the screening, she said, “is a little bit more than an X-ray, a lot less than you get for a CAT scan. They’re just looking for nodules in the lung, they don’t need the higher dose.” People get more exposure in radiation from the environment around them, she explained.

The oncologist said the pilot study will follow up on its patients to demonstrate its value in preventative health care.