Why high-risk individuals should get screened for lung cancer — even if you’ve quit smoking

11:56 AM, Jun 04, 2020

Lung cancer affects thousands of people every year, with almost 230,000 new cases expected this year, according to the American Cancer Society. Additionally, the survival rate for lung cancer is low compared to other cancers, often because of how late it is detected.

“The vast majority of cases are detected at a stage when there’s no meaningful therapy,” said Douglas Adams MD, a cardiothoracic surgeon with the TriHealth Heart Institute and surgical director of thoracic oncology at TriHealth. “They’re detected in late stage three or stage four when a patient develops symptoms and they get a further workup. Symptoms of lung cancer often present themselves so, so by the time those symptoms are obvious, it is beyond a cure.”

In fact, more than half of people with lung cancer die within a year of being diagnosed, according to the American Lung Association. So, what can you do to prevent the worst?

Early detection

If you are diagnosed with lung cancer early, when the disease is still localized, the 5-year survival rate is significantly higher than if it is diagnosed in later stages. Unfortunately, there are few recognizable symptoms at early stages, which is why screening is important if you are in a high-risk group, even when you feel fine.

High risk groups include those 55 and up who smoke or who quit smoking less than 15 years ago and have had 30 “pack years.” You can calculate pack years by figuring out how long you smoked equal to a pack a day. So, if you smoked two packs a day, you would have reached 30 pack years in only 15 years.

The benefits of screening are clear, as illustrated by research into annual low-dose CT scans that showed 80 percent of people with lung cancer were diagnosed at an early stage, Dr. Adams said. It is unusual for an insurance company to not cover the cost of annual screenings because of their effectiveness.

“Lung cancer screening is actually more effective than mammography or colonoscopy,” Dr. Adams said. “One out of 800 colonoscopies saves a life and one out of 1,200 mammograms saves life. Because lung cancer screening is intended specifically for those at-risk groups, one out of 350 scans saves a life from lung cancer.”

What to expect

A screening is simple, with an appointment lasting about 15 minutes, and the imaging itself taking a mere 15 to 20 seconds.

Following the screening, a radiologist will review your images and send the results to your doctor, who will help you determine the next step. Up to 30 percent of people screened have something that requires more imaging several months down the road, Dr. Adams said.

“If there’s nothing, the next scan will be in a year,” he said.

If your results are inconclusive, TriHealth quickly offers a biopsy option. This will allow doctors to insert a thin tube, called a bronchoscope, down your throat to collect concerning tissue, and then diagnose or dismiss the possibility of cancer right away, instead of making you wait for another screening.

If you have lung cancer, treatment often includes surgery to remove the nodule. A surgeon can determine the least invasive technique necessary to remove the nodule from each individual patient.

“Robotic technology has significant refined lung surgery,” Dr. Adams said. “Recovery time in the hospital is often less than three days and people are generally back to their normal routine within three weeks.”

Talk to your doctor about requesting a lung cancer screening, or contact the TriHealth lung cancer screening clinic at 513-865-1145. For more information, visit TriHealth.com.