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Lung Cancer – Screening

April 4, 2021
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"Lung cancer screening is a new preventative tool that was developed in the last decade. This screening protocol was developed based on a paper in the early 2010s, which showed that screening with patients that were high risk for development of lung cancer did improve their overall mortality. Patients that would benefit from lung cancer screening are in the age range of 55 to late 70s, usually around 77 or 78, depending on the exact guideline, they have at least a 30 pack-year smoking history, they've smoked within the last 15 years. And the screening protocol includes a low dose CT scan on an annual basis. The annual CT scan is performed until we get to at least 15 years since the patient has quit smoking. Lung cancer screening should be done at specialized centers with plan for a treatment course if a nodule is detected on the screening CT scan. So therefore, these centers should have access to interventional radiology, interventional pulmonary medicine, as well as the treatment physicians, including medical oncology, radiation oncology, and thoracic surgery. There are pros and cons to lung cancer screening. In terms of the pros, we are more likely to detect the lung cancer at an earlier stage when the patient really isn't having any symptoms of the lung cancer itself. By detecting at an earlier stage, we're more likely to be able to use localized therapy, including either surgery or radiation to go for a complete cure. On the other hand, lung cancer screening also has downsides. Downsides include frequent need for CT scanning. The protocol tells us to do a CT scan on an annual basis, and this amount of CT imaging does add up over time. In addition, if a patient is detected to have a nodule or suspicion for lung cancer on a CT scan, this can lead to more invasive procedures, including CT guided biopsy or more frequent imaging studies, leading to general stress and anxiety for the patient over the time as they are getting further workup. Careful discussion of both the pros and cons of lung cancer screening should be discussed between the patient and the physician before a decision is made to proceed with lung cancer screening."

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