According to the American Cancer Society, one out of every four cancer deaths is attributed to lung cancer, making the disease the leading cause of cancer death among men and women. Princeton Baptist Medical Center has joined other hospitals in the Brookwood Baptist Health System in the fight against the disease by offering low-dose lung CT scanning.
85 percent of lung cancers in the United States are directly related to smoking, and the risk continues even after the person stops smoking. In 2013, the US Preventative Task Force (USPTF) recommended low-dose CT scans for the early detection of lung cancer. Patients in numerous studies who received low-dose CT scans showed a 20 percent decrease in lung cancer mortality and, based on collected study data, the USPTF suggested that low-dose CT screening should begin at age 55 and continue until age 80.
The lung cancer screening program is activated at all five Brookwood Baptist Health hospitals, including Brookwood, Citizens, Princeton, Shelby, and Walker Baptist medical centers. The Princeton Baptist screening program started in September. "Our goal is to screen patients who are at the highest risk for the future development of lung cancer in such a way that we catch the cancer early but don't deliver a large dose of radiation," says Allen Groves, MD, Radiologist and Chief of the Low Dose Lung CT Program at Princeton Baptist Medical Center.
CT scans of the chest provide more detailed pictures than chest x-rays and are better at finding small abnormal areas in the lungs. Low-dose CT of the chest uses lower amounts of radiation than a standard chest CT and does not require the use of intravenous contrast.
Each screening includes a consultation, personalized risk assessment and a physical evaluation along with the a painless, non-invasive, low-dose CT scan. Results and recommendations are available within 72 hours of screening, and patients have ongoing communication with referring physicians. Medicare and many insurance plans cover lung cancer screening for patients who meet the criteria.
Patient eligibility criteria is:
- Age 55-80,
- Current smoker
- Former smoker within the last 15 years
- 30 pack per year history or more
- Smoking cessation counseling has been performed
"The person being scanned must be able to lay flat with his arms above the head for a short time and must not have metal rods or bullet fragments in the mid-back. The person also must be free of any signs of active lung infections or lung cancer and must be willing to go forward with additional tests and procedures if necessary," Groves says. "These are strict guidelines, but our nurse navigator does a good job screening orders and speaking with patients by phone to make sure all criteria are met."
According to the American Cancer Society, about one in four screening tests will show something abnormal in the lungs or nearby areas that might be cancer. Most of these abnormal findings will not be cancer, but more CT scans or other tests will be needed to be sure.
"In the case of an abnormal finding, both the patient and physician will receive a letter about additional testing or a possible referral to a pulmonologist or thoracic surgeon depending on what they find. The nurse navigator will call them also," Groves says. "We will make sure the patient undergoes the next step, whether it is a diagnostic exam, a biopsy or another kind of procedure. Our steering committee meets quarterly and we discuss patients who have positive results and have been referred for a next exam in a different health care system. We still want to make sure they are getting the best next step in their care."
Groves appreciates the help of all who have worked to establish the screening programs in the various hospitals. "Our nurse navigator has worked hard to get the program up and running and to make sure the rest of us are doing our jobs correctly," Groves says. "I am grateful for the help of our steering committee which consists of an oncologist and a thoracic surgeon. Everyone has been supportive and has pitched in to help establish these programs."