Assessing the Value of Lung Cancer Screening
By Michael Ebright, MD, FACS, FCCP, Director of Thoracic Surgery
A recent article in the New York Times by Paula Span clearly illustrates the importance of the “shared decision-making” between physician and patient regarding lung cancer screening.
Low-dose CT screening for lung cancer is much more than a spot-check; it is an intervention that has associated benefits as well as risks. Anxiety, false-positives, subsequent procedures, and radiation exposure are all part of the equation. However, it must be kept in mind that lung cancer screening indisputably saves lives.
Lung cancer creeps in without causing symptoms, which is why the overwhelming majority of cases are discovered at an incurable stage. This is tragic, and enormously frustrating for physicians. Screening is the only way we can find these cases when meaningful intervention is possible; it is the single most important advance in the field I have seen in my career thus far.
In my short time at Stamford Hospital, we have already discovered ten patients through screening who have undergone curative modality treatment for lung cancer. In my view, although the risks of screening are real, they are very much overstated. My ten patients who have undergone curative therapy will undoubtedly agree with me. In fact, CT screening saves more lives per patient screened than mammography or colonoscopy—by far.
The truth is that the National Lung Screening Trial likely underestimates lives saved, as it only scanned patients over a two-year period. If you are in the high-risk group (age 55-77 and current or recent heavy smoker), talk to your doctor about whether lung cancer screening is right for you. In order maximize the benefit and minimize the risk, make sure you enroll in a screening program managed by a multidisciplinary group of lung cancer specialists, and approved by both the Lung Cancer Alliance and the American College of Radiology.
You can read Paula Span’s article, “On Medicare and Assessing the Value of Lung Cancer Screening,” here.