Despite the decrease in smoking rates, lung cancer is prevalent. The rates of lung cancer are higher in Kentucky than in any other state.
It's the second most common cancer in men, behind prostate cancer, and women, behind breast cancer.
It is the most common cause of cancer-related death in both sexes.
To help change that, there is an increasing interest in developing a screening test to detect and treat this devastating disease early enough to improve survival.
A useful screening test must not only be safe, accessible, and affordable; it must improve survival and it must be used in the appropriate population. Because nine of 10 lung cancer patients have a history of smoking, it is appropriate to screen those who have smoked for a long period. Screening a high-risk group increases the possibility of detecting abnormal findings. But what screening test is best to use? There have been various approaches to try to detect lung cancer early, including sputum analysis, blood cancer markers, chest X-rays and chest computed tomography (CT) scan.
Interesting data from the National Lung Screening Trial was published in August 2011 indicating that screening with a low-dose CT scan of the chest is better than chest X-ray in detecting early lung cancer. The researchers concluded for the first time that low-dose chest CT scan reduces lung cancer mortality. The biggest challenges are the cost and the complications of evaluating non-cancerous lung nodules found on screening. This is especially difficult in Kentucky, where the rate of non-cancerous nodules is high because of histoplasma (a fungus) in the Ohio Valley air.
We are getting closer to developing a satisfactory screening test for lung cancer. Using low-dose chest CT scans in high-risk populations is a good way to start. However, multiple questions have to be answered — the best way to decrease the cost, a good algorithm to handle the screening results, the frequency of testing, and the duration of screening — before we can adopt it in the community. These are not routinely offered unless you are in a high-risk group. You can ask your doctor for such a scan, but it is not likely to be covered by insurance.
You might be able to find a place that would agree to a scan without a doctor's order if you self-paid, but I know Central Baptist Hospital does not do that now.
Because an ounce of prevention is better than a pound of cure, a simple, safe and cost- effective way to decrease lung cancer risk is to quit smoking today.