Doctors are recommending a new type of lung-cancer screening for adults at high risk for the disease, which is the deadliest cancer in both men and women.
Earlier this year, Medicare began covering the screenings, which use low-dose CT scans instead of X-rays. A number of private insurers also cover the screening.
Johnston County residents had a chance to learn about the screening last week during a free Johnston Health Chat. Dr. Marvaretta Stevenson presented the latest research and recommendations to about 25 people. Stevenson is a physician with the Duke Oncology Network and medical instructor at Duke University Medical Center.
In 2010, Stevenson said, researchers completed a study of more than 53,000 people with a high risk for lung cancer. The study compared the benefits of yearly screenings using low-dose CT scans versus yearly chest X-rays.
“This study was stopped early when it showed that the low-dose CT scans reduced your chances of dying by 20 percent compared to the chest X-ray,” she said.
Currently, the annual screenings are recommended only for people considered to have a high risk of developing lung cancer, Stevenson said.
A person’s risk level depends on age and a number of risk factors, namely the number of “pack years” a person has smoked in his or her life.
To determine pack years, multiply the number of packs of cigarettes smoked each day by the number of years smoked. For example, a person who smoked one pack a day for 30 years would have a history of 30 pack years, as would a person who smoked two packs a day for 15 years.
To be classified as high risk, a person must be age 55 or older, have smoked 30 or more pack years and have continued to smoke within the last 15 years.
Alternatively, a person age 50 or older with 20 pack years is considered high risk if he or she has one other risk factor. Those include family history; having other lung diseases such as COPD and pulmonary fibrosis; previous bouts with cancer; and exposure to diesel fumes, coal smoke, chromium, nickel, radon, asbestos, arsenic, silica, beryllium or cadmium. Although dangerous, second-hand smoke is not considered a risk factor in this assessment.
Once the screening begins, Stevenson said, doctors look for lumps and other abnormalities so they can track whether they grow in size or density. Depending on what they find, more frequent screenings might follow.
Screening does not in any way replace the need to quit smoking, Stevenson said.
“If you’re a current smoker and you start getting screened for lung cancer, that doesn’t mean that you should just keep smoking,” she said.
Johnston Health does not currently offer low-dose CT screening for lung cancer, but the hospital hopes to change that by autumn, said Caroline Hester, administrative director of outreach services. Johnston Health has all of the necessary imaging machinery, Hester said, but Medicare has data-collection requirements to become a registered screening site.
“There’s a lot of detail that’s involved in that,” she said.
Gregg, a Four Oaks man who preferred not to give his last name, said last week’s seminar marked the first time he had attended a Johnston Health Chat. The topic caught his attention, he said, because he recently quit smoking after 34 years and has grown concerned about developing lung cancer.
“I thought it was very good and very informative,” he said.