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Merlene Davis: New lung cancer screening is good news, may promote survival rates

Finally, there's some good news regarding lung cancer.

Studies have found that low-dose CT scans, along with a good lung cancer program that includes prevention awareness and smoking cessation, have reduced lung cancer deaths by 20 percent.

The low-dose screenings are the first to be developed to help detect lung cancer in the early stages. Heretofore, lung cancer, which can be asymptomatic, often has been diagnosed after it has moved to another area of the body, which then produces a noticeable problem.

But the screenings are recommended only for high risk patients, including those who have smoked a pack of cigarettes a day for 30 years, or those who smoked 2 packs a day for 15 years, and are 55 to 80 years of age. The patient can be a smoker or one who has quit within 15 years.

Until January, when those screenings will be covered by Medicaid and private insurers compliant with the Affordable Care Act, the cost of those screenings could come out of your wallet. In January, the screenings will be covered, with patients paying only their co-pay.

Medicare is looking at the study results and should issue a statement about coverage by Nov. 15.

Of course, that coverage disappears if Obamacare is repealed "root and branch," as some Kentucky politicians would have it.

Maybe they don't know that lung cancer is the leading cause of cancer-related deaths in this country and worldwide, or that Kentucky leads the nation in lung cancer deaths by far. According to United States Cancer Statistics, from 2007 to 2011, the incidence of lung cancer in Kentucky was 41 percent higher than the rest of the country. At that same time, our rate of deaths from lung cancer was 39 percent higher that the rest of the country.

If any state needs Obamacare, we do.

Jennifer Redmond Knight, co-investigator of the Kentucky Cancer Consortium Lung Cancer Prevention and Early Detection Network, said the Affordable Care Act requires insurers to provide tobacco-cessation support, such as prescription medicine or counseling in group settings.

"It's another option for those who come in and who have been struggling to quit smoking," she said. "Being a nonsmoker is the best thing to do, even with healthy individuals."

The network, Knight said, also focuses on educating people about environmental risks for lung cancer, such as radon and secondhand smoke. It brings health care workers, community leaders and policymakers together to find the "right and accurate messages that resonate with the public," she said. "We have got some great, great work happening. We are going to make same strides. It is everybody working together."

A big part of her optimism is tied to the availability and success of the low-dose scans.

Dr. Timothy Mullett, a thoracic surgeon at the University of Kentucky, said research has found that when lung cancer is detected in the early stages, as with breast and prostate cancer, the survival rates are much improved. When detected in later stages, the survival rate is less than 10 percent.

National Lung Screening Trials, through the National Cancer Institute, enrolled nearly 54,000 current or former heavy smokers from 33 sites and coordinating centers nationwide from 2007 to 2010. The University of Louisville was one of those coordinating centers.

The results were good enough for several organizations to recommend the screenings to high-risk patients who showed no symptoms.

But those screenings present another challenge, Mullett said, because they might show an abnormality that isn't cancer, such as histoplasmosis. In those cases, he said, a more invasive follow-up test should be conducted.

Any report of an abnormality should be accompanied by an appointment for a surgeon or to a lung cancer program, Mullett said. "A relationship has to be involved," he said.

Or the screening might come back clean, a result that could give a smoker a false sense of security and a license to continue to smoke.

"The screening should not just be the scan," Mullett said. "It should be part of a program. What we should be doing is saying they are at risk and need to have not just one scan, but a scan every year."

They also need to stop smoking and have their homes checked for radon, the second-leading cause of lung cancer, and asbestos.

Information about the screenings, smoking cessation and radon will be available at the fourth annual Free to Breathe Lung Cancer 5K Run/Walk and 1-Mile Walk on Nov. 1 at Coldstream Park. The event raises money for lung cancer research, with the goal of doubling lung cancer survival by 2022.

I have survived two cases of lung cancer, both found in the early stages. A cough led to my first diagnosis, and follow up CT scans detected the second one.

It works.

I get mammograms to scan for breast cancer and a colonoscopy for colon cancer. Smokers should definitely get the screening test that could save them from lung cancer.

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