Simplified lung cancer prevention, screening guidelines

By | January 7, 2014

"The first step towards preventing lung cancer is avoiding cigarettes which cause 85 percent of diagnoses," said Dr. David Madtes, director of the Lung Cancer Early Detection and Prevention Clinic at SCCA. "For those at higher risk, early detection is the key to survival. Low-dose CT screening for patients at high risk saves lives by empowering doctors to detect lung cancer at an earlier stage with the option of removing it surgically."

Cigarette smoke contains more than 7,000 chemicals, many of them cancer-causing substances (carcinogens) that damage the cells in the lungs, greatly increasing an individual’s risk of developing lung cancer. Additionally, smoking increases the risk of more than a dozen other cancers, including cancers of the mouth, nose and sinuses, esophagus, liver, pancreas, stomach, kidney, bladder, cervix, and bowel. Research also shows that patients already diagnosed with cancer benefit from quitting their tobacco use. Benefits include fewer complications when receiving various cancer treatments, better outcomes from treatments, and improved quality of life and survival rates.

While the risk of lung cancer increases with the length of time and number of cigarettes smoked, it’s never too late to quit. Just five years after quitting smoking the risk for developing cancers of the mouth, throat, bladder, and esophagus is cut in half. Through SCCA’s Lung Cancer Early Detection and Prevention Clinic, individuals can access the Living Tobacco Free Program which includes support from tobacco-cessation counselors. With a goal of aiding individuals in becoming comfortable and confident non-smokers, counselors offer a variety of approaches, including medication to manage nicotine-withdrawal symptoms, tools to manage stress, strategies to break the habit of smoking, and educational information about other resources for quitting. To date, four out of five active smokers cared for in the Prevention Clinic have participated in our smoking cessation program.

SCCA lung cancer experts believe early detection is a proven and successful strategy for fighting lung cancer for those at high risk for lung cancer. Furthering this belief, a National Lung Screening Trial published in June 2011 showed that by detecting lung cancer at its earliest stage and removing it surgically, patients can expect a five-year survival rate close to 70 percent. As a result of these findings, the United States Preventive Services Task Force (USPSTF) recently published a revised recommendation for lung cancer screening. Following the USPSTF guidelines, SCCA recommends anyone with a high risk for developing lung cancer should be screened annually with low-dose computed tomography (CT). The USPSTF and SCCA define high risk as:

• Ages 55 to 80 years old

• A history of heavy smoking (Heavy smoking is smoking for 30 "pack years" or more. A "pack year" is smoking an average of one pack of cigarettes everyday for a year.)

• Current smokers or those who have quit smoking within the past 15 years

While lung cancer screening has not traditionally been a routine part of preventive medical care like mammography for breast cancer screening, the results of the NLST trial and USPSTF recommendations are changing clinical practice such that lung cancer screening should be offered to individuals at high risk for lung cancer. Through the Lung Cancer Early Detection and Prevention Clinic, SCCA lung cancer experts support screening to provide the opportunity to detect lung cancers at an earlier, treatable and curable stage and offer low-dose computed tomography (CT) screening for high risk patients.

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