November 22, 2016 | by Letisia Marquez
Caught early, lung cancer can often be successfully treated and cured. But it often isn’t diagnosed until a patient develops symptoms. By then, the disease has advanced, making it difficult to treat.
“About 20 percent of all lung cancers are detected as Stage 1, and almost always those cancers are found by accident,” Raz explained. For instance, a patient who is scheduled to receive knee surgery might have a chest X-ray that finds a cancerous lung nodule.
“But a low-dose CT scan detect anywhere from 60 to 85 percent of Stage 1 lung cancers,” he said. “We have a better chance of successfully treating lung cancers that are Stage 1 or 2. Early detection is what saves lives. We see a shift from an incurable to a curable cancer.”
A recent study by Raz in the Journal of Thoracic Oncology addressed misconceptions many primary care doctors have, and what can be done to address them.
As part of the study, Raz and his team surveyed 250 primary care doctors in Los Angeles County. About half of the primary care physicians interviewed were not aware of the lung cancer screening recommendations. Several misconceptions about lung cancer screenings were also identified:
Misconception No. 1: Insurance plans don’t cover lung cancer screenings
Approximately 54 percent of doctors believed that insurance won’t pay for lung cancer screenings. But health insurance, including Medicare, covers the screenings for people between the ages of 55 and 77 who have smoked a pack a day for 30 years and still smoke, or those who have quit within the past 15 years.
“The recommendation by the U.S. Preventive Task Force is that everyone who falls into that at-risk category should get screened for lung cancer every year,” Raz said.
Misconception No. 2: The benefits of a lung cancer screening are not clear
Nearly 30 percent of doctors in the study indicated they did not think that high-risk patients would benefit from a lung cancer screening. The U.S. Preventive Task Force, American Cancer Society and National Comprehensive Cancer Network, among others, recommend screenings for patients who are at high risk of developing lung cancer. One of the largest randomized, controlled clinical trials in the National Cancer Institute’s history showed that the screening could reduce lung cancer mortality rates by at least 20 percent.
Misconception No. 3: Lung cancer screenings are not cost effective
A lung cancer screening is more cost effective than mammography, a commonly used breast cancer screening test, Raz said. When asked to compare lung cancer screenings and mammography for female smokers, most primary care physicians agreed that lung cancer screenings are not something they think about as much as mammography, and that the benefits of a mammography were greater than a lung cancer screening.
In addition to more educational outreach to both patients and physicians in order to demonstrate how lung cancer screenings can save lives, Raz also has also another suggestion: Since most primary care doctors already collect a patient’s smoking history, a system could also be developed to provide an electronic alert when a patient meets the criteria for a lung cancer screening.
“The test is so simple – in one deep breath, we can take a scan of a patient’s entire chest cavity,” Raz said. “It’s such a quick screening, and it can save your life.”