Screening for Lung Cancer

Jess Dalehite, M.D.

Southwest Medical Imaging

Midland Memorial Hospital

Lung Cancer the Killer

• 160,000 deaths from lung cancer each year.

• More than breast, colon, prostate and pancreas

combined. More women die of LC than BC.

• Most lung cancer is not curable when it is

discovered.

• By the time it becomes symptomatic it has

already spread.

Cure for Lung Cancer

• Early detection and surgical removal before

it spreads is the only way to cure lung

cancer.

• Lung cancer that has spread can be treated

with chemotherapy and radiation but the 5

year survival rate for metastatic lung

cancer is around 5%.

How to Screen for Lung Cancer

• CXR has been a miserable failure.

• Checking sputum for cancer cells doesn’t

work.

• Routine diagnostic CT scanning is good

but the radiation dose is too high to

screen every year for life.

The Solution: LDCT

• LDCT= Low Dose CT to screen for lung cancer.

• Painless 10 sec scan without IV contrast.

• We dial the radiation dose down to 20% of a

normal diagnostic chest CT.

• Can detect a lung cancer as small as 1/16 of an

inch.

Who should get a LDCT?

• Older patients with a long history of smoking.

• Age: 55-79 y/o

• Smoking history: At least 30 pack year history.

• Quit smoking less than 15 years ago.

• Future: Maybe 5o y/o with a 20 pack year

history.

Who Pays?• The scan currently costs $300 at

MMH.

• Medicare, Medicaid and Private

Insurance currently do not pay.

• Recent thumbs up by USPSTF that

will mandate payment under

Obamacare.

How effective is it?• Screening studies are evaluated by

how many people must be screened

to save one life.

• Breast screening with

mammography= 1000

• Colon screening with colonoscopy=

800

• Lung screening with LDCT= 350.

Saving Lives

• 20% reduction in mortality for those

who are screened annually for 3

years.

• That’s 38,000 American men and

women each year!!!

Odds

• The vast majority of people who smoke will never

develop lung cancer. COPD, other cancers.

• Heavy smokers are at the greatest risk.

• Lung cancer is a curable disease if discovered early.

• Heavy smokers have already made one mistake,

why compound it with another; not getting

screened?

Free Screening in September

• MMH is offering free LDCT for those

who fit the criteria and have an order

from their doctor for the test.

• Scheduling is available on each

Saturday of September.

• Call 682-XRAY (682-9729)

Questions?