Newswise — CHICAGO: Lung cancer causes the most deaths from cancer in the nation, accounting for about 1 in 4 of all cancer deaths in the U.S. Screening for lung cancer is one of the most effective ways to detect lung cancer at its earliest stages when it is most treatable and even curable. Unfortunately, far too few Americans – only about 6% of eligible patients – are routinely screened for lung cancer, resulting in thousands of preventable deaths every year.
For Lung Cancer Awareness Month and National Smoking Cessation Month, the American College of Surgeons (ACS) supports the second annual National Lung Cancer Screening Day on November 11, which aims to enhance access to lung cancer screening and raise awareness of lung cancer.
Throughout the month, cardiothoracic surgeons, Timothy Mullett, MD, MBA, FACS, and Luis A. Godoy, MD, FACS, of the ACS, are available to discuss who should be screened for lung cancer, and why smoking cessation programs need to be made more widely available and accessible to all patients. Members of the media may email [email protected] to schedule an interview with Dr. Mullett or Dr. Godoy.
What is National Lung Cancer Screening Day?
The second annual National Lung Cancer Screening Day will be held on Saturday, November 11, 2023, coinciding with Veterans Day. Health care centers around the country are encouraged to open their doors to eligible patients to provide easier access to lung cancer screening services. The event, which is supported by the ACS and other organizations, aims to improve access to and awareness of lifesaving lung cancer screening services.
“National Lung Cancer Screening Day is a way to make lung cancer screening more accessible to patients and to offer screening to patients at convenient times, after hours, and on weekends to accommodate people who are working and have a busy schedule,” said Dr. Mullett, Chair of the ACS Commission on Cancer (CoC) and Medical Director of the Markey Cancer Center Network Development at the University of Kentucky. “For lung cancer, the first domino to fall was to prove that lung screening works. Now, the barrier is an awareness and access issue.”
The state of Kentucky, where Dr. Mullett is based, has a lung cancer screening rate of about 13% – more than double the national average – and serves as a model for promoting screening to at-risk populations. An advocate and leader in lung cancer awareness and smoking cessation resources, Dr. Mullett recently participated in an initiative of President Biden’s cancer panel, Reducing Cancer Care Inequities: Leveraging Technology to Enhance Patient Navigation, and was also part of a forum in June focused on expanding equitable access to smoking cessation programs.
Why is screening for lung cancer so important?
Lung cancer kills more people than prostate cancer, breast cancer, and colorectal cancer combined. Most symptoms of lung cancer – such as chest pain, difficulty breathing, or coughing up blood – don’t appear until the cancer has already spread and is more difficult to treat.
A powerful screening tool – a low-dose CT scan of the chest – has been proven to save lives by detecting lung cancer before symptoms appear, and when the cancer is most treatable and even curable. Unfortunately, only about 6 % of the eligible population is screened for lung cancer. In some states, screening rates are as low as 1 %.
What does screening involve?
The recommended screening tool for lung cancer is the low-dose CT scan, which takes only a few minutes to complete and, in many ways, is less invasive than a colonoscopy or mammogram testing. There is very little prep work involved for the exam and no needles or contrast dye are used.
“The proven mechanism for lung cancer screening is the low-dose CT scan, that’s what’s been shown in the largest randomized control trial ever done in the country,” Dr. Mullett said. “Other screening tools for lung cancer are being tested that include genomic testing and blood tests, but those have not gone through the same rigorous scrutiny of the low-dose CT scan.”
Who should be screened for lung cancer?
The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screenings with a low-dose CT scan for adults ages 50 to 80 with a 20-pack-year smoking history who currently smoke or have quit smoking within the past 15 years. The American Cancer Society also recently broadened its guidelines to encourage screening among this same population regardless of how many years ago they quit.
A pack year is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, a patient who smoked two packs per day for 10 years would have a 20-pack-year smoking history.
“The calculations are a little confusing for a lot of patients, so in most instances, I recommend that patients talk to their primary care provider if they are concerned about lung cancer or want to be evaluated to see if they are a candidate for screening,” said Dr. Godoy, assistant professor in the Section of General Thoracic Surgery at UC Davis Health. “A primary care provider can help them do the calculations to see if they are eligible or not.”
Dr. Godoy also recommends being as honest as possible during annual physical exams and appointments. Health care providers are not here to judge anyone who smokes or has smoked: “Some people overestimate how much they smoke and others underestimate. A patient may say, ‘I smoke half a pack a day,’ but if their spouse is in the room, they will say, “No, it’s more like a pack and a half every day.’ Be honest so we can provide you with the best recommendations possible.”
What about people who don’t smoke but are worried about lung cancer?
Smoking and heavy exposure to secondhand smoke are leading risk factors for lung cancer, but 10 to 20 percent of lung cancer cases occur in people who have never smoked or smoked very little in their lifetime. Unfortunately, current preventive screening guidelines do not apply to people worried about lung cancer due to environmental exposure, such as from radon or asbestos, or those who have a family history of lung cancer where genetics may play a factor. However, these people can still talk to their doctor about their concerns and screening options. Preventive guidelines are also evolving and may be updated to recommend routine screening in some of these groups.
“If a patient is concerned about lung cancer due to environmental exposure or has family members they are concerned about, they should talk to their primary care doctor and discuss these concerns,” Dr. Godoy said.
How can smoking cessation programs be made more accessible to patients?
Quitting smoking can dramatically reduce the risk of developing lung cancer, but is also important for several other health reasons, especially for patients undergoing cancer treatment.
Continued smoking can negatively affect cancer treatment, yet routine discussions about smoking cessation and referrals to programs are not routinely incorporated into cancer care.
Through the Just ASK and Beyond ASK quality improvement projects, the ACS is leading efforts to promote more equitable access to empathetic and personalized smoking cessation resources, including support groups and medications.
“We need to be having more frank conversations about smoking cessation. Quitting smoking can not only reduce the risk of getting cancer, but it can also reduce the risk of dying from other smoking-related illnesses that may occur during or after cancer treatment,” said Dr. Mullett. “Just as we have experts in surgery, we also have experts in tobacco treatment, and we want more people to have access to programs that provide people with the tools they need to quit smoking.”