Lung cancer results in more deaths in the United
States than any other cancer; in fact, it accounts
for more deaths than breast, cervix, colon, and
prostate cancer combined.
Because lung cancer has no symptoms in its early
stages, more than 85 percent of the men and women
who are diagnosed with lung cancer today are diagnosed
in a late stage, after symptoms occur and when
there is very little chance of cure. As a result,
approximately 95% of the more than 200,000 people
diagnosed each year die from the disease.
With early detection, 85 percent of cancers can
be found in the earliest, most curable stage.
If treated
promptly with surgery, their 10-year survival
rate is 92% (New England Journal of Medicine 2006:
355: 1763-1771).
7. Why is lung cancer screening especially
important in communities of color?
In communities of color--which traditionally
have limited access to health care information,
diagnostic
procedures, and medical treatment--lung cancer
kills at disproportionate rates. The disease accounts
for 25 percent of all cancers diagnosed in African
American men; this is almost double the rate of
lung cancer deaths for the overall US population.
The lung cancer mortality rate for African American
men in the 1990s was over 46 percent higher than
that of white men. Cancer death rates among African
American women are 20 percent higher than among
white women.
Unfortunately, less data are available on Hispanic
men and women. The American Lung Association
recently reported that "smoking behaviors
and lung cancer rates differ among different segments
of the
Hispanic population, and closer examination is
needed to get a more accurate picture of each
group."
8. How will I benefit from a low dose
lung cancer screening CT?
The benefits of lung cancer screening CT scans
are highest for those with significant lung cancer
risk.
Current research has focused on patients at a
high risk for lung cancer. Several factors contribute
to lung cancer risk: age; smoking history; environmental
exposure to carcinogens like asbestos, beryllium,
uranium, or radon; and exposure to second hand
smoke. The older you are and the more you've
smoked or been exposed to smoke and other carcinogens,
the higher your risk will be.
A recent study found that women were twice as
likely as men to develop lung cancer when comparing
similar smoking histories. The study was published
in the July 2006 issue of the Journal of the American
Medical Association and involved 17,000 subjects
from CT screening sites across North America.
In the study, women were found to have 1.9 times
the risk of developing lung cancer as men when
the results were analyzed to control for age and
smoking histories.
Based on this research, it is even more critical
that teen girls and young women avoid smoking
cigarettes, even on a social basis. The findings
suggest that women's lung cancer risk can
be significantly affected by even light tobacco
smoking.
While women are twice as likely to develop lung
cancer, they are half as likely as men to die
from it once it has developed. Because of this,
women can gain even greater benefit from early
detection lung screening.
9. What is the evidence that lung
cancer screening saves lives?
The latest research from ongoing studies shows
that patients diagnosed with lung cancer as a
result of
annual CT screening have an overall 10-year survival
rate of 80%, regardless of stage and type of treatment.
When cancers are found at the earliest stage (85%
of the patients) and are immediately removed with
surgery, the research shows a 10-year survival
rate of 92%. The research involves over 31,000
patients who are considered to be at risk for
lung cancer due to a combination of their age
and histories of cigarette smoking, occupational
exposure to carcinogens, or exposure to second-hand
smoke (New England Journal of Medicine 2006: 355:
1763-1771).
The initial findings of the study, published
in The
Lancet, a prestigious medical journal, and
on July 9, 1999 on the front page of The
New York Times, showed that 85% of the cancers
that are found with CT screening are small and
in the more curable early stage.
Chest x-rays done at the same time failed to
reveal 85 percent of the early-stage cancers detected
by the CT scans. It was already well-known that
small early stage lung cancers are much more curable
than those found in later stages as 10-year survival
rates of 90% or more had been reported by others.
10. I’ve had chest x-rays
before, why would I want to have this scan?
A chest x-ray shows only two views of your chest
(front and side), while a CT scan shows cross-sectional
images all through your chest-from the very top
of your lungs through the lung bases. Thus, tiny
abnormalities (that could be early stage lung
cancer) can be found which would never have been
seen on a chest x-ray.
11. Will this test (CT) show other lung
abnormalities besides cancer?
Yes. Old or new pneumonia, tuberculosis, or emphysema
may be detected.
12. Will my heart be evaluated on the
low-dose chest CT?
A limited evaluation will be done. The radiologists
are able to see heart size and can detect calcifications
in the coronary arteries when present. It also
can detect abnormal dilatations of the main blood
vessels leading out of the heart. These results
will be reported to your doctor.
13. Who is eligible for the screening?
Individuals age 40 or over; smoking history of
10 years or more; family history of lung cancer;
environmental exposure greater than 10 years (secondhand
smoke, radon, large city living, other
environmental exposure).
14. How much does the screening cost?
The fee is $325, payable at time of registration
(cash, check or charge – insurance does
not currently cover this screening). If a positive
or questionable finding is seen and follow-up
procedures are required (such as a diagnostic
CT scans or biopsy) the participant is responsible
for the costs either through insurance or selfpayment.
15. What will screening participants
be asked to do?
Each participant, with guidance from the Nurse
Navigator, will be asked to fill out a confidential
screening questionnaire on smoking habits and
other relevant risk factors for lung cancer. Participants
also must sign a standard CT scan consent form.
16. Are there any risks involved?
Risks associated with being screened include
finding abnormalities that need additional tests
and that are ultimately benign (not cancerous).
These tests can cause anxiety and on some occasions
lead to invasive procedures such as biopsy to
further determine whether a finding is a cancer.
I’m interested.
17. How do I make an appointment?
If you are interested in being screened, we recommend
that you discuss the risks and benefits with your
doctor so that it is a shared decision. If you
have any questions about the process or decide
you want the screening, please call the Nurse
Navigator at 404-851-5175 or email canscreen@sjha.org
Please be prepared to give the following information:
- Your name, address, phone number, birth date
and family history
- Your physician’s name and number.
- Two possible appointment times convenient
for you
18. How long will my appointment take?
The actual CT scan takes about 5 minutes in total
(with set up and scanning time). You are only
scanned forless than 20 seconds, while you hold
your breath. The registration and interview with
the Nurse Navigator may add an additional 25-30
minutes to your visit. We recommend setting aside
one hour of your schedule for this appointment,
even though it is unlikely that the entire hour
will be necessary.
19. Where is the screening?
The CT scan is done in the Outpatient Imaging
Center (OPIC) on the campus of Saint Joseph’s
Hospital, located at 5671 Peachtree Dunwoody Road,
Suite 100.
20. Where do I park?
Any visitor parking on campus is appropriate,
but the closest parking for the OPIC is beside
the 5673
Building. When you enter the campus from Peachtree
Dunwoody Road, bear left away from the Hospital.
You will come to a dead end /stop sign. Turn right
and the 5671 Building is on the right –
valet parking is $6 at the front door. Come in
the building and go down one floor, the OPIC is
in the lobby on level one.
21. When can I schedule an appointment?
We are making appointments now. Please call the
Nurse Navigator at 404-851-5175.
Resources:
www.ielcap.org
www.cancer.org
www.lungcanceralliance.org
