October 23, 2020

Lung Cancer Screening Could Save Your Life: What You Need to Know

 By Jean Comeau, RN, BSN, Nurse Navigator for Harrington HealthCare’s Lung Cancer Screening Program

Lung cancer is the second most common type of cancer in the U.S. It is also the leading cause of cancer deaths, even among non-smokers. Each year, more people die of lung cancer than of breast, prostate and colon cancers combined.

According to the Centers for Disease Control (CDC), in 2017 (the latest year for which data is available) more than 221,000 new cases of lung cancer were reported in the U.S. and nearly 146,000 people died of the disease. Here in Massachusetts, there were more than 5,000 new cases of lung cancer reported that same year.

Because lung cancer is so common and also the most common cause of cancer-related death, it’s important to know what the risk factors are, and to get screened on a yearly basis if you have certain risk factors. Here’s what you need to know…

Lung Cancer Risk Factors

Risk factors for lung cancer include:

• Smoking –
  Smoking is the number one cause of lung cancer; it is linked to about 80% to 90% of lung cancer deaths. People who smoke are 15 to 30 times more likely to get lung cancer than people who do not smoke. The more a person smokes and the longer he or she smokes, the greater the risk for developing lung cancer becomes. The good news is that quitting smoking at any age can lower that risk.
• Exposure to radon –
  The second-leading cause of lung cancer in the U.S. is radon. Radon is a naturally occurring gas that comes from the ground and can be trapped in houses and buildings. According to the U.S. Environmental Protecton Agency, radon causes about 20,000 cases of lung cancer each year.

  The EPA classifies our region of Worcester County, Massachusetts, as a high-radon area. You should have the radon levels in your home tested. If they are found to be high, there are radon-mitigation systems that can be installed to clear the radon from your living environment. You can find more information about radon testing and mitigation in Massachusetts at gov/service-details/radon-get-the-facts.

• Other environmental factors and family history –
  Other causes of lung cancer include exposure to substances such as asbestos, arsenic, diesel exhaust and some forms of silica and chromium, as well as prior radiation therapy to the chest. You may also have a higher risk of developing lung cancer if your parents, siblings or children have had lung cancer.
  

Lung Cancer Screening: Who Should Be Screened and When

By the time most lung cancers are detected as a result of symptoms alone, the cancer has usually spread widely and advanced to a stage that is much more difficult to treat or cure. But with screening for those who are at most at risk, lung cancer can be found at earlier stages, when it is more treatable and more likely to be cured.

Low-dose computed tomography (also known as a low-dose CT scan or LDCT) is the only recommended screening test for the early detection of lung cancer. In 2013, the U.S. Preventive Services Task Force (USPSTF) set out recommendations for who should receive yearly lung cancer screening.

People who meet ALL of the following criteria should be screened annually:

• Are between the ages of 55 and 77 years old
• Are currently a smoker or have quit within the past 15 years
• Have a 30 pack-year history of smoking
  (A pack year is defined as smoking pack of cigarettes per day for one year. So someone could have a 30 pack-year history of smoking if they smoked one pack per day for 30 years or two packs per day for 15 years, for example. Because people often vary their smoking habits over the years it can be difficult to determine if you meet the 30-pack-year guideline – this pack-years calculator can help.)

Just this past July, the USPSTF released a draft of new recommended guidelines for lung cancer screening that in the future could expand eligibility for screening to people as young as 50 (instead of the current minimum age of 55) with a 20 pack-year history of smoking (instead of the current 30 pack-year history).

Lung Cancer Screening: How to Get Screened and What to Expect

In 2015, Harrington HealthCare joined a growing list of organizations across the nation offering an Early Detection Lung Cancer Screening Program and in 2019 the program earned Accreditation by the American College of Radiology. In addition, Harrington’s Cancer Center has been designated a Lung cancer Alliance Center of Excellence for two years in a row. Since the program’s inception, Harrington has performed over 5,000 lung cancer screenings.

Our comprehensive program brings the pa­tient together with his or her physician and radiologists from Beth Israel Deaconess Medical Center for the screening. If an abnormality is found, the program engages oncologists and pulmonologists to help in the diagnosis and, if necessary, collaborate on an individualized plan of care.

If you are concerned about your risk for lung cancer, talk with your primary care physician to see if you are a candidate for our Early Detection Screening Program. A physician referral is required, but most insurance plans cover this screening for eligible individuals. To learn more, call (508) 765-3024.

If your PCP recommends a lung cancer screening, here is what you can expect…

Step 1: The Screening

A lung cancer screening consists of a CT scan that allows physicians to look at a detailed pic­ture of your lungs to detect any abnormalities. A CT scan is the only proven, effective way to screen for lung cancer.

The identified highest, at-risk patient population who should be screened are those who:

• Are between the ages of 55 and 77;
• Are current smokers, or who have quit in the last 15 years;
• Have a personal history of 30 “pack years” — meaning you smoke one pack a day for 30 years, two packs a day for 15 years, etc.

Low-dose CT scans expose people to an extreme­ly low level of radiation. The test is painless and takes less than 10 minutes to complete.

Step 2: Results and Follow-Up

Lung scans are categorized as RAD 1 to RAD 4, with 1 being negative and 4 being highly suspicious with additional testing(s) recommended. In 2019, Harrington performed over 1,400 early detection lung cancer screenings.

If your results show an abnormality, you will meet with your doctor who will discuss the find­ings and the next steps in your individualized care plan. As with any screening test, there is the possi­bility of a false positive result. Abnormal find­ings may require additional testing.

Jean Comeau, RN, BSN, is an interventional radiology nurse and the nurse navigator for Harrington’s Lung Screening Program in Southbridge. For questions regarding the program, call (508) 765-3024.