Transcript Screening for Lung Cancer

Screening for Lung Cancer
Jess Dalehite, M.D.
Southwest Medical Imaging
Midland Memorial Hospital
Lung Cancer the Killer
• 160,000 deaths from lung cancer each year.
• More than breast, colon, prostate and pancreas
combined. More women die of LC than BC.
• Most lung cancer is not curable when it is discovered.
• By the time it becomes symptomatic it has already
spread.
Cure for Lung Cancer
• Early detection and surgical removal before it
spreads is the only way to cure lung cancer.
• Lung cancer that has spread can be treated
with chemotherapy and radiation but the 5
year survival rate for metastatic lung cancer is
around 5%.
How to Screen for Lung Cancer
• CXR has been a miserable failure.
• Checking sputum for cancer cells doesn’t work.
• Routine diagnostic CT scanning is good but the
radiation dose is too high to screen every year for
life.
The Solution: LDCT
• LDCT= Low Dose CT to screen for lung cancer.
• Painless 10 sec scan without IV contrast.
• We dial the radiation dose down to 20% of a normal
diagnostic chest CT.
• Can detect a lung cancer as small as 1/16 of an inch.
Who should get a LDCT?
• Older patients with a long history of smoking.
• Age: 55-79 y/o
• Smoking history: At least 30 pack year history.
• Quit smoking less than 15 years ago.
• Future: Maybe 5o y/o with a 20 pack year history.
Who Pays?
• The scan currently costs $300 at MMH.
• Medicare, Medicaid and Private Insurance
currently do not pay.
• Recent thumbs up by USPSTF that will
mandate payment under Obamacare.
How effective is it?
• Screening studies are evaluated by how many
people must be screened to save one life.
• Breast screening with mammography= 1000
• Colon screening with colonoscopy= 800
• Lung screening with LDCT= 350.
Saving Lives
• 20% reduction in mortality for those who are
screened annually for 3 years.
• That’s 38,000 American men and women each
year!!!
Odds
• The vast majority of people who smoke will never
develop lung cancer. COPD, other cancers.
• Heavy smokers are at the greatest risk.
• Lung cancer is a curable disease if discovered early.
• Heavy smokers have already made one mistake, why
compound it with another; not getting screened?
Free Screening in September
• MMH is offering free LDCT for those who fit
the criteria and have an order from their
doctor for the test.
• Scheduling is available on each Saturday of
September.
• Call 682-XRAY (682-9729)
Questions?