Lung cancer screening is conducted by low dose CT scan and now widely accepted as a standard of care for those who are at high risk for lung cancer. A low dose CT (LDCT) scan is about 8 times less the radiation exposure than a standard diagnostic CT scan and very sensitive to picking up something as small as a grain of rice in the lungs including an early stage lung cancer; this is when you want to pick up a lung cancer. In fact, this sensitivity means there is a 24%-30% chance there will be abnormal findings on CT scan but largely, these findings will not be cancer or ever pose a problem.
This is an exciting and pivotal time for those at risk for lung cancer and those caring for patients on the front lines of healthcare. This recent recommendation and understanding that LDCT screening in high-risk people saves lives and also means we have a responsibility to screen patients safely.
Screening is a continuum of care in which LDCT is recommended on an annual basis or sooner, depending on the results of the CT scan. Patients who have early detection of lung cancers in the screening process vastly improve their chances of survival. This survival has improved from a 15% and 5-year survival (no screening) to an 80% and 10-year survival (screened by low dose CT scan).
Given the significant probability that there will be abnormal findings in the screening process, it is critical that lung cancer screening by LDCT scan is conducted in a controlled and multidisciplinary clinical setting. Such a setting offers patients high levels of care including quality radiology standards and health experts who are experienced in the early detection, diagnosis and management of lung cancer. In this setting, patients can enjoy the benefits of screening and avoid unnecessary procedures including imaging and procedural complications.
The United States Preventive Services Task Force (USPSTF) and other prominent groups have strongly recommended that screening be conducted in a safe and responsible way. The Center for Medicare and Medicaid Services (CMS) have outlined specific requirements for the clinical setting in which lung cancer screening occurs. Swedish Lung Cancer Screening Program meets and exceeds these recommendations and requirements through the following criteria, which are provided with each patient encounter:
- Careful patient selection by adherence to the USPSTF eligibility criteria.
- Quality control in screening: standardization of LDCT imaging, interpretation and ongoing surveillance.
- A lung cancer multidisciplinary team that carries out a coordinated process for screening, reliable follow up, and treatment when appropriate.
- Close collaboration and partnership with dedicated, expert radiologists.
- Electronic mechanism that provides quality control and outcomes metrics.
- Electronic mechanism in place for dependable recall and ensure that abnormal findings get appropriate follow-up.
- Face-to-face encounter with an emphasis on shared decision-making and personalized patient education.
- Active engagement of Primary Care Providers and other care providers.
- Tobacco cessation counseling and treatment by a trained specialist for patients who are smoking.
Commercial insurers are now reimbursing for lung cancer screening and in the first quarter of 2015, Medicare and Medicaid health plans will also reimburse. To learn more about screening and to see if you, a friend, or loved one qualify for lung cancer screening you can call 206-386-6800 or visit www.swedish.org/LCSP
