The Importance of CT lung screening
Anchor: Welcome back to We Are Austin. Lung cancer is the deadliest type of cancer in the U.S., and unfortunately, most times, people get very sick before they really figure out the problem. Dr. John Williams, with ARA Diagnostic Imaging, shares what you need to know to help catch cancer early which is really the key, isn’t it?
Doctor: It is, it really is! Screening is the key to a lot of these tests. It gives the treatment the best chance of working. So, this is a relatively new arena for us. In the past – well, first of all, it’s an important disease process to address. Lung cancer still accounts – it’s the number one, leading cause of cancer-related deaths in the United States every year, in men and women. That includes up to 150,000 fatalities.
Anchor: Oh wow!
Doctor: People who succumb to lung cancer every year. Part of that is because we haven’t done a great job in the past of being able to identify it in its early form and find the lung nodules when they are small and when therapy would be more effective. I think a good comparison is breast cancer. So, that’s actually a more commonly diagnosed form of cancer, but fortunately it’s much further down on the list of mortality, or people who die related to it. That’s because there are good treatments, but because there’s also a really good screening tool which is mammography.
Doctor: We’re able to catch that disease process early and affect treatment outcomes. So, in the past with lung cancer, we’ve kind of relied primarily on chest x-rays, which is a good tool but not as good at catching the nodules when they’re small and when the treatment would be more effective. We end up kind of catching them when they are later when the disease process is more advanced, and so, therefore, the treatments are not as good.
Anchor: You’re limited, yeah.
Doctor: This examination, CT lung screening, when applied in the appropriate population can actually reduce cancer-related – lung cancer-related deaths – by up to 20%, which is, you know, significant.
Anchor: Wow! That’s significant!
Anchor: It truly is. Who is a good candidate for a CT lung screening? Who should really be keeping an eye out for this?
Doctor: So, it’s effectively very heavy smokers. Greater than 90% of people with lung cancer have a history of smoking.
Doctor: This is even a cohort within that. Basically, people have what’s called a 30-pack-year history of use, which is a way of describing that they have smoked the equivalent of a pack of cigarettes a day, every day of their life for 30 years.
Doctor: So, that’s a lot. They’re in between the ages of 55 and about 77, and they continue to smoke or they’ve only stopped smoking in the past 15 years.
Anchor: Oh wow.
Doctor: Within that group of people, that’s where we see that significant reduction.
Anchor: Looking here at the traditional chest x-ray, which you mentioned before…
Anchor: It just doesn’t quite do as much as the CT.
Doctor: Right! We still use it all the time and its sort of the bread and butter for pneumonia and that kind of stuff. We can see lung nodules on there. You’ll see the comparison. This is a CAT scan in the same sort of plane. You can see a lot more detail, so it makes it much easier for us to be able to discern smaller nodules. For instance, this is just an example of a relatively large one. They really stand out on this modality and help us detect the cancer early.
Anchor: You can see the difference there. Smokers really are the people who really should be paying attention for the CT. Is there anyone else who should be thinking about this?
Doctor: That’s a good question, because it sounds like it’s such a great test, and why doesn’t everyone get it? Studies have shown though that because not every lung nodule that we see is cancer, it’s not a good test to apply to just the general population. You end up with a lot of false positives. So, it’s really just best to apply it to that subset of heavy smokers.
Anchor: Yeah. That’s very, very important to know. You’re looking at a slide here of that group who should really be paying attention to this.
Anchor: If you really want to know how to learn more about this CT lung scan and you do feel like you fall into that high-risk group, what should we do?
Doctor: Have the conversation with your healthcare provider and confirm you’re in that group that would benefit. Then, you basically get a referral to have this examination done. We suggest having it done at a facility that has been accredited as a lung cancer screening facility by the American College of Radiology. That’s because those facilities are able not only to perform the test, but they have to meet certain requirements to do the necessary follow up. So, we identify these nodules, and then we can’t just let these findings go unchecked. We need to follow up on them, maybe get a biopsy, and get on to the next level of care.
Anchor: People do often talk about radiation. There may be concerns when people are hearing about the CT lung scans. What are the concerns there?
Doctor: Sure! We do hear about that. Part of our job as radiologists is to always basically minimize the dose of radiation that you receive while still having a diagnostic examination. This CT is about a third of the dose of a regular chest CT and that’s because it is a screening examination. So, we anticipate people to have several over the course of their life, so we have to be more aware of kind of the cumulative dose.
Anchor: Very, very good to know. This is important information. Early detection really sounds like it truly is key to saving lives.
Doctor: It really is. Absolutely!
Anchor: How can we learn a little bit more and where can we go for more information?
Doctor: We have a lot of information actually on our website, ausrad.com, or give us a call ARA Diagnostic Imaging.
Anchor: Excellent! This has been really important information. Thanks for joining us! It’s great to see you.
Doctor: Thanks for having me!
Anchor: Happy Holidays!
Doctor: You too!