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Screening for Lung Cancer
Jess Dalehite, M.D.
Southwest Medical Imaging
Midland Memorial Hospital
Lung Cancer the Killer
• 160,000 deaths from lung cancer each year.
• More than breast, colon, prostate and pancreas
combined. More women die of LC than BC.
• Most lung cancer is not curable when it is
discovered.
• By the time it becomes symptomatic it has
already spread.
Cure for Lung Cancer
• Early detection and surgical removal before
it spreads is the only way to cure lung
cancer.
• Lung cancer that has spread can be treated
with chemotherapy and radiation but the 5
year survival rate for metastatic lung
cancer is around 5%.
How to Screen for Lung Cancer
• CXR has been a miserable failure.
• Checking sputum for cancer cells doesn’t
work.
• Routine diagnostic CT scanning is good
but the radiation dose is too high to
screen every year for life.
The Solution: LDCT
• LDCT= Low Dose CT to screen for lung cancer.
• Painless 10 sec scan without IV contrast.
• We dial the radiation dose down to 20% of a
normal diagnostic chest CT.
• Can detect a lung cancer as small as 1/16 of an
inch.
Who should get a LDCT?
• Older patients with a long history of smoking.
• Age: 55-79 y/o
• Smoking history: At least 30 pack year history.
• Quit smoking less than 15 years ago.
• Future: Maybe 5o y/o with a 20 pack year
history.
Who Pays?• The scan currently costs $300 at
MMH.
• Medicare, Medicaid and Private
Insurance currently do not pay.
• Recent thumbs up by USPSTF that
will mandate payment under
Obamacare.
How effective is it?• Screening studies are evaluated by
how many people must be screened
to save one life.
• Breast screening with
mammography= 1000
• Colon screening with colonoscopy=
800
• Lung screening with LDCT= 350.
Saving Lives
• 20% reduction in mortality for those
who are screened annually for 3
years.
• That’s 38,000 American men and
women each year!!!
Odds
• The vast majority of people who smoke will never
develop lung cancer. COPD, other cancers.
• Heavy smokers are at the greatest risk.
• Lung cancer is a curable disease if discovered early.
• Heavy smokers have already made one mistake,
why compound it with another; not getting
screened?
Free Screening in September
• MMH is offering free LDCT for those
who fit the criteria and have an order
from their doctor for the test.
• Scheduling is available on each
Saturday of September.
• Call 682-XRAY (682-9729)
Questions?