Lung cancer is the number one cancer killer. Not all lung cancers can be prevented but there are things you can do to lower your risk. By working to detect it early and encouraging people to avoid all controllable risk factors, we hope to prevent more deaths from this disease. Join us to expand your knowledge on the latest non-invasive low-dose CT scan test. We will also discuss who is likely to be at risk, who should be tested, and key health steps to take to prevent this deadly disease.

1. Breathing Easy:
Lung Cancer Prevention and
Screening
Jessie S. Wilt MD
Pulmonary and Critical
Care Medicine
Summit Medical Group

2. Lung Cancer Prevention
• DO not smoke
• Quit Smoking
• Keep Quitting...Just keep quitting
• Smoke Less
• See your physician...you will be glad
you did

4. Quitting
• Pharmacotherapy
 Bupropion/Zyban, Varenicline/Chantix,
Nicotine replacement – patch, gum,
lozenge
• Behavioral modifications
 Cut down/cold turkey, uncoupling triggers,
support groups/quit partners
• Just keep quitting...Smoke less

5. Lung Cancer
• Leading cause of Cancer deaths
 Takes more lives than breast, ovarian, and
colon cancer combined
• Third most common Cancer in the US
• Does not cause symptoms until it is
either large or out of the lung and on the
move...at a point where treatment
cannot cure

6. Lung Cancer Screening
• What is SCREENING
 Screening looks for a disease BEFORE
and patient has symptoms
 Goal to detect cancer at the earliest and
potentially MOST CURABLE stage
 Low risk, least invasive, inexpensive, able
to repeat with little impact to the patient,
rely on those results, accessible
 BENEFIT far greater than any risk

7. Lung Cancer Screening

8. Low Dose CT Scan (LDCT)
• Low Dose CT is a "CAT" scan that uses
a low dose of radiation
• Uses a computer and basically a series
of small 2 mm x-ray images
• Screening is NOT for everyone
 Only patients at HIGH risk for lung cancer

9. WHO should be screened
• AGES 55-80
• CURRENT or FORMER smoker who
quit within the past 15 years
• Smoked at least 30 pack-years
 1 pack per day for at least 30 years
 2 packs per dayfor 15 years
 3 packs per day for 10 years

10. Who should NOT be screened
• Younger or older than range 55-80
• Unwilling to have treatment for cancer if
detected
• Smoked less than 30 pack-years
• Other Medical problems that would
prevent surgery or treatment
• Unwilling to have repeated CT scans
• You have signs of Lung cancer

11. Signs of Lung Cancer
• New cough that will not go away
• Change in chronic cough
• Coughing up blood
• Accelerated weight loss without trying
• Pain in the chest wall, ribs, spine
• These ARE NOT specific to lung cancer

12. Screening Without Listed
Risk Factors
• Likely will not benefit from LDCT, test
was not designed to detect ALL forms of
lung cancer in all patients
• FALSE positive
 50% of patients have nodules, less than
2% of nodules are cancer even in high risk
 Need for more testing and EVEN invasive
testing

13. Non-smoking Risk Factors
• Family history of lung cancer
• Exposure to asbestos or radiation
• Second Hand smoke
• Other lung conditions such as
emphysema or pulmonary fibrosis
• Prior therapeutic radiation (for
lymphoma)

14. National Lung Cancer
Screening Trial
• Screening reduced lung cancer death
rate by 20%
 For every 1,000 people who DID NOT get
screened, 21 people died from lung cancer
 For every 1,000 people who DID get
screened, 18 people still died from lung
cancer
• 300 people need to be screened to
save ONE life.

15. Risks of Screening: False Positive
Results
• 50% of patients WILL have a nodule
• Less than 2% of these nodules will
represent cancer
 NEED to pursue further testing (365/1000)
 Invasive procedure to make sure it is not
cancer (25/365)
 Complications of invasive procedures
(3/25)

16. Lung Cancer Risk Calculator

19. Additional Harms of LDCT
• Can still miss the most dangerous
 Still 18/1000 people screened died from
lung cancer
• Radiation Exposure
 Amount of radiation is LOW
 Risk of Cancer is HIGH
• False Positive

20. False Positive Results
• 50% of patient will have nodules
• More CT scans/More radiation
• Invasive procedures
• Anxiety and Stress
• False reassurance to keep smoking
• Treatment for a slow growing cancer
 May not have resulted in death

21. Reduce Harms of Screening
• Do not get screened if you do not have
risk
• Work with a team of lung cancer experts
for evaluation of a "positive" scan
• Quit smoking
• Keep in close contact with your
physician

23. Future/Research
• Making the CT MORE sensitive and
specific
• Blood TEST
 MDA research protocol
 Standard and NON-standard risk factors

24. Thank you!!!!
Questions?