Lung Cancer Screening Program
The U.S. Preventive Services Task Force (USPSTF) recommends lung cancer screening with low-dose computed tomography (CT) scans of the chest for individuals at high risk for developing lung cancer.
We developed our Lung Cancer Screening program to meet all of the task force's requirements, including a multidisciplinary review of CT scans with nodules that are greater than 8mm in size and using one of the few ultra low-dosage CT scanners in Portland.
It is important to note that 27% of patients who get a screening CT will have some abnormality on their CT scan, but only 1% of them will end up having cancer; 10% will have some abnormality unrelated to their lungs.
Criteria for screening eligibility:
- People age 50-80
- Current, or former smokers who have quit within the last 15 years
- Individuals with at least a 20 pack-year history of smoking
- Individuals who would be willing and able to undergo curative treatment
If you or a loved one meets the above criteria:
Call The Oregon Clinic Pulmonary, Critical Care & Sleep Medicine at 503-963-3030 to refer yourself to The Oregon Clinic Lung Cancer Screening Program. Most insurance providers are approving screening CT scans at this time (of note, Medicare is now covering lung cancer screening, but only patients up to age 77). Check with your insurance provider to ensure your screening will be covered.
Our Lung Cancer Screening Program also includes
- Providing resources and counseling for smoking cessation
- Offering patients more information and answers patient questions about lung cancer and screening
- Explaining that the report will go to their physician/provider and The Oregon Clinic Lung Cancer Screening program
1. How much of a problem is lung cancer?
Lung cancer is the leading cause of cancer deaths in the US. Lung cancer accounts for almost 25% of all cancer deaths—more than colon cancer, breast cancer, and prostate cancer combined.
Most lung cancers are diagnosed at an advanced stage where cancer cells have spread to lymph nodes or other parts of the body. Approximately 85% of lung cancers have spread to lymph nodes or other parts of the body at the time of diagnosis. We know that diagnosing cancers at an earlier stage, before the cancer has spread to lymph nodes or other parts of the body provides a much better chance of cure. For example, the likelihood that someone will survive for 5 years with a lung cancer that has spread to other parts of the body (metastasized) is only about 4%, compared to about 55% for cancers that are localized only to the lung.
Up until recently, we have not had an effective strategy for screening for lung cancer. That has now changed with the use of ultra-low-dose CT scans.
2. Do I need a doctor's referral for lung cancer screening?
If you meet the inclusion criteria for lung cancer screening, you may refer yourself by calling The Oregon Clinic - Pulmonary, Critical Care & Sleep Medicine at 503-963-3030 or completing this online form.
3. What does lung cancer screening cost?
Most insurers will cover the cost of lung cancer screening for patients who meet the inclusion criteria.
If there any questions regarding whether insurance will cover the cost of screening, our staff at The Oregon Clinic can help determine your insurance coverage.
4. What are the risks of lung cancer screening?
One of the concerns with lung cancer screening is that CT scans use x-ray equipment, which exposes you to radiation. The level of radiation exposure from a ultra-low-dose CT scan is a 50 - 70 percent less than a usual CT scan, and the risk of complications from this low dose of radiation, even if someone receives multiple low-dose CT scans over a period of years, is thought to be very, very low. With the ultra-low-dose chest CT scans that we use at The Oregon Clinic, the radiation exposure is roughly equivalent to the natural background environmental radiation exposure over a period of 6 months, or as much as 15 traditional x-rays.
One of the keys to successful lung cancer screenings is to avoid unnecessary biopsy procedures and surgery. This is where having a group of experts to review the scans and help decide what to do is absolutely critical. In the three years of screening during the National Lung Cancer Screening Trial, abnormal findings on the CT scan occurred in 27 percent of the patients, and more than 90 percent of those abnormalities turned out not to be lung cancer.
5. If the screening scan is normal, does that mean I will not get lung cancer?
The best way to prevent lung cancer is to never smoke or to stop smoking now. The Oregon Clinic is committed to helping you quit smoking.
Even after receiving a normal scan, individuals that meet the screening criteria would still be considered at high risk for lung cancer. Our team of experts continue to do yearly scans for high-risk individuals.
Because 85% of lung cancers are related to smoking, it remains critical that you continue to work on quitting smoking and we have a number of programs to help.
6. What impact does Lung Cancer Screening have on lung cancer outcomes?
The largest trial of lung cancer screening to date, the National Lung Cancer Screening Trial (published in 2011), included 53,000 individuals at high risk for developing lung cancer, and showed that heavy smokers were 20% less likely to die from lung cancer if they underwent a screening with CT scans. The overall mortality in the screening group was 6.7% less than in the group that did not receive CT scans.
7. Why do Lung Cancer Screening?
- To find lung cancer at an earlier stage, when treatments are more effective
- To improve the chances of survival from lung cancer
- Lung cancer screening is now recommended by the USPSTF for individuals at the highest risk for lung cancer
8. What is Lung Cancer Screening?
Lung Cancer Screening uses ultra-low-dose CT scans of the lungs performed once each year for smokers or former smokers at high risk for developing lung cancer to detect lung cancer BEFORE there are symptoms.
9. What happens if something is found on the screening CT scan?
In the largest study of lung cancer screening, 27% of patients had an abnormality on the screening CT scan, but MOST of these abnormalities turned out NOT to be cancer and did not require procedures. If anything suspicious is found on your CT scan, our lung cancer screening program providers are here to help guide you through the appropriate steps. If a lung cancer is discovered, our goal is to ensure that you get state of the art treatment as soon as possible.
If the scan shows a small nodule that could be a cancer, you will require a repeat CT scan within a few months to determine if there really is a cancer. However, if a larger nodule is found, the results will be reviewed by a panel of experts to determine if further testing, such as a biopsy, bronchoscopy, or surgery, is required. Any significant abnormalities are reviewed by a team of lung specialists, radiologists, lung surgeons, and radiation and medical oncologists.
10. Why choose Lung Cancer Screening at The Oregon Clinic?
Lung cancer screening involves more than just a CT scan. Our team of lung cancer experts includes nationally recognized lung specialists, radiologists, lung surgeons, radiation oncologists, and medical oncologists with expertise in lung disease. At the Oregon Clinic, you will find a dedicated group of providers with a focus on multidisciplinary, patient-centered care. In addition to providing screening for lung cancer, we can also help provide support and resources to help you quit smoking, which remains the most important thing you can do to decrease your risk for lung cancer!
Resources for Smoking Cessation
- Open 7 days a week, 24 hours a day.
- Coaching is available in many languages.
For help in English:
- Text: READY to 200-400
- Call: 1-800-QUIT-NOW (1-800-784-8669)
Español: 1-855-DEJELO-YA (1-855-335356-92)