About lung cancer screening
Lung cancer screening attempts to identify cancer at an early stage, when the cancer is limited in size and location. Identifying lung cancer early has been shown to make treatment more effective and can help reduce the risk of death. Researchers also study lung cancer screening tests to help identify traits that put people at greater risk of getting lung cancer, as well as to refine the screening tests to make them more accurate in identifying lung cancers and reducing the risk of death.
cCARE’s approach to lung cancer screening
Unfortunately, we often see patients with lung cancer diagnoses too late for a cure to be possible. The entire staff at cCARE is committed to making a difference in lung cancer care through improving early detection.
We approach the screening process as a team. Our physicians, nurse practitioners and supporting staff work diligently to recognize our patients’ needs including timely follow-ups, addressing immediate concerns and more.
The lung cancer screening program at cCARE San Diego is directed by Dr. Joel Lamon.
What is an LDCT lung cancer screening?
According to the Centers for Disease Control and Prevention, the only recommended screening test for lung cancer is a low-dose CT scan (LDCT). In this screening test a computerized program is applied to a CT (computerized tomography) scanner to quickly scan the lungs at the lowest radiation exposure that will capture clear images. This process replaces the chest X-ray to look for lung abnormalities that may indicate lung cancer. The LDCT requires no injections and only five minutes in the scanning machine.
Radiation risk
The main concern with an LDCT screening is radiation exposure. Radiation exposure is expressed as a Sievert value (Sv). This is a unit of measurement of the “effective dose” of radiation to the entire body.
The average person in the United States receives an effective dose of about 3 millisieverts (mSv) per year from natural radiation and cosmic radiation. This background radiation exposure varies according to one’s location.
A diagnostic lung CT scan has radiation exposure of 7 mSv, while an LDCT scan has an effective exposure of 1.5 mSv.
What to expect at a LDCT screening at cCARE San Diego
cCARE’s lung cancer screening program begins with an assessment of a patient’s lung cancer risk factors including smoking. During this appointment, the rationale, risks, benefits and screening procedure will be reviewed in detail.
If the physician and patient decide to move forward with an LDCT screening, it can be arranged within the hour. After the screening, patients will be given a summary of the visit and a CD with images from the procedure.
The images are then read by a trained lung cancer screening staff member, and the patient is informed of the findings. A physician will then make a recommendation based on these findings. Typically, these recommendations are to schedule a follow-up screening in one year or include instructions for further studies.
Who should get screened?
In 2011, a study of 53,454 current and former smokers known as the National Lung Screening Trial found that participants who had LDCT screenings reduced their risk of death by 15 to 20 percent over participants who received standard chest X-rays. We strongly recommend this screening for anyone meeting the guidelines as described below.
cCARE follows the guidelines of Medicare and the National Comprehensive Cancer Network (NCCN) in recommending LDCT lung cancer screening.
Medicare guidelines
- Between the ages of 55 and 77.
- Have no signs or symptoms of lung cancer.
- Either be a current smoker or have quit smoking within the last 15 years.
- Have a 30-pack year or greater history of cigarette smoking.
Heavy smoking is defined by the duration and daily intensity of smoking. This is expressed as “pack years” of cigarette exposure. A pack year is the number of cigarette packs smoked per year multiplied by the number of years the person smoked at that rate. For example, smoking one pack per day for 30 years would be defined as a 30-pack year cigarette exposure.
NCCN guidelines
- Age 50 years or older.
- Have a 20-pack year of smoking and additional risk factors such as family history, asbestos exposure, etc.
- Second-hand smoke is not considered an additional risk factor.
Anyone who meets the guidelines can have the LDCT screening procedure. cCARE will review the patient’s history and determine if the guidelines for screening have been met. A physician can also refer patients to cCARE for an LDCT.
Insurance and cost
Because we recognize what a valuable, life-saving tool it can be, we want to make the LDCT lung cancer screening as affordable and open to patients as we can. The lung cancer screening with the LDCT at cCARE San Diego is $350 and is covered by Medicare, if all of the guidelines (mentioned above) have been met.
Unfortunately, there is no certainty of coverage by other insurers. cCARE will provide an insurance claim form for LDCT lung cancer screening regardless of whether or not the patient has met the Medicare or NCCN guidelines.