To Screen or Not to Screen for Lung Cancer?

A new study in CHEST, a peer-reviewed medical journal covering chest diseases and related issues, determined that a structured prescreening counseling and shared decision-making visit with health care professionals leads to a better understanding of the benefits and risks, as well as the eligibility criteria, of lung cancer screening using a low-dose CT scan.

This is an important finding because lung cancer screening using a low-dose CT scan can be a lifesaving test for high-risk patients, but while it offers clear benefits, incidental findings and radiation exposure mean there are some potential risks associated with yearly screening.  Most patients do not fully understand the benefits or potential harms of a screening program, nor are they clear on exactly who should undergo testing.

For the study, investigators designed a program that involved a counseling and shared decision-making visit for patients prior to starting lung cancer screening.  These visits were divided into different educational components focusing on eligibility requirements, the benefits and harms of lung cancer screening, and the personalized benefit and risk for each participant.  Patients were encouraged to ask questions during sessions.  After analyzing pre- and post-visit surveys, investigators found participants initially had a very modest understanding of the eligibility criteria, benefits, and harms of screening. After viewing educational materials and participating in the shared decision-making process with the practitioner, follow-up surveys showed patients had a better grasp on the nuances of screening.

“We found a generally poor level of understanding of the eligibility criteria, benefits, and harms of screening upon entry into the program,” explained lead investigator Peter J. Mazzone, MD, MPH, FCCP, Director of the Lung Cancer Program for the Respiratory Institute and the Lung Cancer Screening Program, Cleveland Clinic.  “This understanding improved substantially after the visit at the time of the decision about whether or not to proceed with screening.  Patients generally felt the messages were delivered at an appropriate level and felt more comfortable about their decision after the visit.”

The American Cancer Society recommends screening for people who are aged 55 to 74 years who have at least a 30-pack-year smoking history, currently smoke or have quit within the past 15 years, and who are in relatively good health.

Louisville CyberKnife advocates screening for lung cancer and encourages patients to discuss low-dose CT scans with their physician to better understand the benefits and risks associated with the screening.  The lung cancer screening program at the James Graham Brown Cancer Center was the first in Kentucky to meet National Lung Cancer Alliance standards.  To learn more about low-dose CT screenings, or to schedule a screening, please click here.