Low-dose CT screening a new way to detect lung cancer

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Chest X-rays and sputum cytology have traditionally been the two ways of screening for lung cancer, but neither has ultimately decreased the number of deaths associated with the disease. Now, low-dose CT scans are being used to detect lung cancer while it is still treatable.


Washington Hospital, in conjunction with Southwestern PA Pulmonary and Sleep Medicine of Washington, is now offering CT screenings to help detect lung cancer at early stages. This service is available to high-risk individuals, including long-term smokers and others with additional pulmonary conditions.


More than 160,000 Americans were expected to die from lung cancer last year, according to the American Lung Association. The results of a national study called the National Lung Screening Trial revealed in 2010 that there were 20 percent fewer lung cancer deaths among individuals who received a CT screening.


CT scans are able to detect pulmonary nodules that may become cancerous long before a patient notices any symptoms.


“That’s the problem. Most of the time, there are no symptoms,” said Charles Koliner, chief of pulmonary medicine and chief of the medical division at Washington Health System.


“Cancers, when they start, are really quite small and tend not to interfere with lung function.”


While the lung cancer screening is not entirely new, it is now more widely available due to the success of studies like the National Lung Screening Trial. It is also less invasive, according to Koliner.


“It’s a little different from existing technology. The scans that are used are much lower energy, so they give less radiation exposure than traditional CT scans,” Koliner said.


The screening CT scan uses one-third of the amount of radiation used by the standard diagnostic CT scan. CT scans can also detect smaller nodules than the ones picked up by X-rays, and as a result, the risk of having a cancerous nodule is reduced. The risk of a nodule being cancerous is 50 percent on an X-ray, while the risk factor is 10 to 20 percent on a CT scan.


Patients receive results in a week or less, and afterward they can follow up with their primary care physician to determine if they need additional tests.


Those who qualify for a screening include those between the ages of 55 and 79 with a 30-pack-year smoking history, or those ages 50 and older with a 20-pack-year smoking history and additional risk factors. One’s “pack year” is determined by multiplying the number of packs of cigarettes smoked per day by the number of years one has smoked.


Individuals could also qualify for the screening if they have a history of lung disease, pulmonary fibrosis or occupational exposures, like silicosis and asbestos.


The fee of the CT scan is $99 at Washington Hospital, which is not yet covered by health insurance.


Koliner believes that over time, early detection screenings will reduce the number of lung cancer deaths among high-risk individuals.


“It does look like it is worthwhile, and it probably will result in increased length of life for a number of people,” Koliner said.


To schedule a screening, call Koliner’s office at 724-222-2577.


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