Lung Cancer Screening Program

According to the American Lung Association, lung cancer is the leading cancer killer in both men and women in the United States and is responsible for around 25 percent of all cancer deaths. In the US, one in 15 men and one in 17 women will be diagnosed with lung cancer in their lifetime. Black men and women are more likely to develop and die from lung cancer than persons of any other racial or ethnic group, a statistic that we, unfortunately, see often.

My name is Susan MacIntyre, and I am the Director of Radiology at Washington Health System (WHS) in Washington, Pennsylvania. I work directly with our Lung Screening program, which we launched in July 2020. This innovative program has allowed us to be proactive about lung cancer diagnosis. According to the American College of Radiology in Feb 2022, lung cancer was named the deadliest cancer for both genders, killing more people each year than breast, colorectal, and prostate cancer combined. Early detection is the key because lung cancer has one of the lowest 5-year survival rates. This is due to a high percentage of patients being diagnosed in the later stages of the disease. The lung cancer screening process is a low-risk procedure that comes with the highest reward of early detection. It can save lives.

My work with cancer screening hits home for me. In 1998, I found out that I had Hodgkin’s Lymphoma. It was discovered completely by accident — I had been volunteering for an MRI scan on a new device when the cancer was found. I completed six months of treatment at a local hospital in Pittsburgh, PA, and have been cancer-free since the end of my chemo treatments. The one positive that came out of such a difficult time in my life is that I now see patient care from a whole new perspective. I keep that perspective in mind throughout my work with patients.

At WHS, we’re on a mission to improve the outlook for people who are at high risk for lung cancer. As the early stages of lung cancer are often symptomless, low-dose computerized tomography (CT) scans can help diagnose those who fall in that high[1]risk category. And it’s been a success.

Program qualifications include those who currently smoke or have stopped smoking within the last fifteen years, are between the ages of 50-77, and have smoked for 20 pack years. A pack year is smoking one pack (or 20 cigarettes) per day or the equivalent. For example, smoking two packs a day for ten years is also equivalent to 20 pack years. This includes those who have since quit.

As with other cancers, early screening can save lives. According to the National Lung Screening Trial, there was a 20 percent decrease in lung cancer deaths when patients were screened with a low-dose CT scan than with an x-ray. Early lung cancer detection makes a significant difference in prognosis. Cancer that is caught in later stages is much more difficult to treat and less successful.

Lung cancer CT screening has been available for some time, but insurance companies have only recently been covering it.

Though this kind of program is not offered in all healthcare systems, we are seeing it offered more and more. The facility must be able and willing to offer this service to the community. With the success of the screening trials and the approval of the U.S. Preventative Services Task Force, most health insurance companies are now covering the cost of the scans for those who are considered high-risk.

I always urge patients who are concerned about their risk of lung cancer to discuss preventative lung cancer screenings with their primary care physician. Your doctor can determine whether you meet the criteria for screening and guide you from there.

Our program utilizes the expertise of a Lung Cancer Screening Navigator. After a patient schedules an appointment, the navigator will contact the patient for more information about their risk criteria and to answer any questions. They remain the point of contact for patients in the program, acting as a resource for more information and coordinating care. We find that this makes the process for the patients smoother and less intimidating. For some patients, the fear of cancer can sometimes prevent them from even pursuing screening. With our navigator, we can offer patients the support they need.

Once the scan is complete, it is submitted to me for review. Higher-risk patients and those with suspicious findings on the scans are jointly reviewed by the Lung Cancer Screening Program physicians such as pulmonologists, radiologists, a thoracic surgeon, and oncologists, to make informed and collaborative decisions for recommendations regarding the next steps in care. Options can include further CT scans, PET scans, or referrals to specialists.

Once accepted into the Lung Cancer Screening Program, patients qualify to receive yearly screening CT scans.

Thankfully, many of our screened patients don’t show evidence of cancer. But it can often be the push they need to quit smoking. As part of the program, we offer our patients resources for smoking cessation. The program supports all aspects of lung cancer risk, from screening to support.

I encourage you to consider a similar screening program. Every early diagnosis is an improved chance for successful treatment. It was for me.

Information about the WHS lung screening program can be found on our website at whs.org/ lungscreening.