Lung Cancer Screening

Call (804) 828-3768 for more information

If you are a long-term, heavy current or former smoker, age 55-77 years, a lung scan from VCU Medical Center may be for you. Read below for more information. If you feel that this scan may be right for you, talk to your provider about having a scan done at VCU Medical Center or call (804) 828-3768 for more information.

The National Cancer Institute (NCI) announced in November 2011, that initial results of the National Lung Screening Trial (NLST) showed high-risk persons who received at least three annual (one per year) low-dose helical CT screens had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays. You can view the article as reported in the New York Times.

What is lung cancer and how common is it?

Lung cancer is a cancer that starts in the lung. Lung cancer is one of the most common cancers in the world. It is the leading cause of cancer death in both men and women in the United States. According to the American Cancer Society, lung cancer claims approximately 160,000 Americans annually, and over 4,000 of those are in Virginia alone. Click here for more cancer facts and figures.

How do I know if I am at risk for lung cancer?

People with a history of cigarette smoking have a high risk of lung cancer. There are more than 90 million current and former smokers in the United States. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of possible lung cancer. While smoking is the largest risk factor for developing lung cancer, high levels of pollution, radiation and asbestos exposure may also increase your risk.

What is Lung Cancer Screening?

Screening means testing for a disease when there are no symptoms, clinical signs, or history of that disease. Screening tests may find a disease early on, when treatment may work better.

What is the benefit of Lung Cancer Screening?

One of the keys to more successful treatment of lung cancer is the early detection of the disease. Often, lung cancer is not detected until it is far advanced and may have already compromised the function of one or more vital organs or have spread beyond the lung into other parts of the body. There are many types of lung cancer. Each type of lung cancer grows and spreads in different ways and is treated differently. The purpose of this screening chest CT scan is to detect and diagnose a potential lung cancer at a much earlier stage, before you develop symptoms, and at a time when you may have more effective and better treatment options. The images will be reviewed for the presence of lung nodules or masses (spots on the lung) or other abnormalities suspicious for lung cancer as well as other potentially important clinical findings.

How do I know if I should undergo Lung Cancer Screening?

In December 2013, The United States Preventive Services Task Force (USPSTF) recommended annual screening with low-dose CT (LDCT) in persons 55-77-years of age with the equivalent of a 30-pack-year of cigarette smoking (smoked at least 1 pack per day for at least 30-years) who currently smoke or had quit smoking within the past 15 years. They further recommended screening should be discontinued once an individual had not smoked for 15 years or developed health problems significantly limiting their life expectancy, ability, or willingness to undergo curative lung resection surgery. The USPSTF evidence suggested implementing a lung cancer screening program with these specific eligibility criteria would detect approximately one half of all lung cancers at an earlier, more treatable and surgically resectable stage and could save as many as 20,000 lives each year.

How is the Lung Cancer Screening test performed?

 

The screening test is performed with a low-dose spiral (helical) CT. The CT scanner rotates around your body, while you lie still on a table that passes through the center of the scanner. The CT scan provides detailed images of the inside of your body, made by a computer that combines the x-ray images taken from different angles. The screening CT can be performed with a single short breath-hold and takes less than 5-10 seconds. You may eat or drink immediately before and after this scan. An IV is not necessary. This test does not use any contrast media (dye).

How much radiation will I receive during the screening Chest CT?

There is a small increased risk of developing some forms of cancer in persons exposed to high doses of radiation. However, the amount of radiation used with our current CT scanners is very small and poses a negligible risk of causing cancer. The amount of radiation associated with the Low-Dose Screening Chest CT is 90% less than what is used with a standard chest CT. For more information regarding radiation safety, you can click here.

How good is the Screening Chest CT in detecting possible lung cancer?

 Because no test is 100% accurate, it is important to understand the limitations of this screening study. It is possible that you may have an underlying medical condition, including lung cancer, that that goes undetected on this Screening Chest CT. This is called a false negative. It is also possible that this Screening CT exam may reveal findings that mimic or are suspicious for lung cancer when indeed you do not have lung cancer. This is called a false positive. In such cases, you may have to under additional imaging tests and even a possible biopsy by a Radiologist or Thoracic Surgeon to prove the finding seen on the Screening Chest CT is not a lung cancer. Lastly, the Screening Chest CT may reveal findings not related to your lungs that may require further work-up with additional diagnostic tests and imaging studies.

Who will be interpreting the results of the Lung Cancer Screening Chest CT?

The Lung Cancer Screening Chest CT will be reviewed and interpreted by one of our team of Thoracic Radiologists. A Radiologist is a physician who has specialized training in obtaining and interpreting medical images, which makes him or her, an imaging expert. These images are obtained by using x-rays (radiographs, CT) sound waves (ultrasound), the body's natural magnetism (MRI) or by the injection/inhalation of radioactive substances (nuclear medicine). A Thoracic Radiologist is a radiologist with advanced training who specializes in the diagnosis of diseases of the chest cavity (thorax and lungs). After reviewing and interpreting your Screening Chest CT, our Thoracic Radiologists will recommend either a follow-up annual Screening CT or the need for further examinations or treatments. These results will be shared with your Primary Care Physician (PCP) who ordered your Screening Chest CT scan. The Thoracic Radiologists can work together with your PCP to determine the best course of action for you. We also have a team of Pulmonologists (lung doctors) and Thoracic Surgeons (lung surgeons) available. This latter group of physicians can be consulted to discuss your case and can become involved in your care and management if you so desire.

Will my private insurance or health care plan pay for the cost of the Screening Chest CT?

Screening Chest CT is covered under traditional Medicare. For commercial insurance, many carriers are covering LDCT. With individual commercial insurance and coverage, you should personally contact your insurance carrier. If your insurance does not cover this screening, payment arrangements will need to be made prior to having the screening CT scheduled to be performed

The Screening Chest CT could also reveal medical conditions or findings where additional testing and or treatment will be indicated. These subsequent tests and or treatments will only be performed after obtaining your permission. The costs for these additional tests or treatments may or may not be covered by your private insurance or government insurance plan. If not covered, the costs of such will be your personal financial responsibility.

The Lung Cancer Alliance offers guidance and resources in regards to insurance coverage for Lung Cancer Screening CT. They can be reached at support@lungccanceralliance.org or 1-800-298-2436

Can anyone help me stop smoking?

Once you have started, we know it can be very difficult to “kick the habit”. We have a dedicated team of smoking cessation experts available for consultation upon your request. For additional information on techniques and methods to help you stop smoking, contact:

Patricia Cafaro, Nurse Practitioner
Clinical Director and Counselor, Tobacco Cessation Program
804-828-4968 (office)   804-827-1748 (fax) patricia.cafaro@vcuhealth.org

Quit Now Virginia: 1-800-784-8669
quitnow.net/virginia
Free phone assistance

The National Cancer Institute: 1-800-4-CANCER

The American Lung Association: 1-800-LUNG-USA

The American Heart Association: 1-800-242-8721

Or visit the Smoking Cessation team on the web at www.cleanairqualitycare.com.

Proud to be a Lung Cancer Alliance Center of Excellence

VCU Department of Radiology Virginia Commonwealth University VCU Medical Center