Low-dose CT increasingly used to identify lung cancer early

Healthcare organizations are increasing their use of imaging technology to detect lung cancer in earlier, more treatable, stages of the disease.

Many providers are offering low-dose computed tomography scans in efforts to identify tumors earlier, often increasing the chances that patients will survive the disease and making treatment easier, often sparing patients from the need to undergo chemotherapy.

The American Cancer Society predicts that more than 220,000 people in the United States will be diagnosed with lung cancer this year. Of those, nearly 142,000 will die of the disease, which is more than will die from breast, colon, and prostate cancers combined.

Those between the ages of 55 and 80 often are at risk for developing the disease, particularly if they have are long-term smokers. Often, it’s been difficult for those at risk to differentiate between the effects of smoking and the signals of lung cancer, raising the risk that they’ll delay diagnosis efforts until late in the course of the disease.

"After decades of having little to offer adults at high risk for lung cancer, we've entered a new era where we now have evidence that lung cancer screening saves lives, and new targeted therapies and immunotherapy are offering new hope to patients diagnosed with advanced lung cancer," says Richard Wender, MD, chief cancer control officer at the American Cancer Society.

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Low-dose computed tomography (LDCT), a newer form of CT scan, is the only screening test for lung cancer recommended by the Centers for Disease Control and Prevention. During an LDCT scan, the patient lies on a table and an X-ray machine uses a low dose (amount) of radiation to make detailed images of the lungs.

Also known as a low-dose spiral or helical CT scan, the imager continuously rotates in a spiral motion and takes several three-dimensional X-rays of the lungs. The resulting images are very detailed and can show early-stage lung cancers that may be too small to be detected by a traditional X-ray.

One provider organization that’s emphasized the use of LDCT is St. Elizabeth Healthcare in Edgewood, Ky. The system, which operates five facilities throughout northern Kentucky and has more than 115 primary and specialty care office locations, recently passed 10,000 lung screenings—it estimated that its 12-month completion rate at 25 percent of eligible patients, compared with 5 percent nationwide, in data it presented at a recent annual meeting of the American Society for Clinical Oncology.

Kentucky ranks worst in the country for lung cancer diagnosis and death rates, according to 2018 data from the North American Association of Central Cancer Registries reported by the American Cancer Society.

LDCT offered by St. Elizabeth has identified about 100 lung cancers under Stage III. Early detection offers more treatment options, enabling St. Elizabeth surgeons and their teams to remove the tumors and often spare lung cancer patients the need for chemotherapy. About 350 at-risk patients are screened per month at St. Elizabeth, detecting a new lung cancer in about one in every 62 scans.

"By finding these tumors at an earlier Stage I or II, we are seeing a 'stage migration' shift. Pinpointing tumors at lower stages significantly increases chances of survival," says Michael Gieske, MD, medical director of lung cancer screening at St. Elizabeth. "The screenings are already extending and saving lives."

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