Lung cancer remains the most common cause of cancer-related death, with mortality higher than breast cancer, prostate cancer and colorectal cancer. In fact, data from the American Cancer Society estimates nearly 5,000 deaths will occur annually in Michigan as a result of lung cancer.
There have been significant improvements in the treatment and management of lung cancer, including biomarker assessments which look for genes, proteins and other substances for the detection of cancer. There have also been major advances in radiation therapy, chemotherapy and immunotherapy. These advances have improved outcomes in patients with lung cancer but have reached a plateau in terms of improvement because the outcomes from treatment is affected by the stage of the lung cancer at the time of diagnosis.
Multiple studies performed in both the United States as well as internationally found that screening patients with risk factors for developing lung cancer decreases mortality from the disease by 20 to 30 percent at five years. The reason? Computed tomography (CT) scans can detect lung cancer very early in its progression, often at an early stage, which translates into better chances of cure and survival rates than were possible before. In fact, the advances in screenings could realistically reduce deaths in Michigan by 1,000 annually. This is a major step forward with lung cancer, making the low-dose CT scan screening the largest improvement in lung cancer outcomes seen to date.
It was with great enthusiasm then that lung cancer screening was made available and recommended by the U.S. Preventive Services Task Force in 2013 for patients with the following characteristics:
- Age: 50 to 80 years old
- Smoking History: 20 or more pack years
- (Pack years = # packs per day multiplied by # years smoked)
- Smoking Status: Current smoker or have quit within the past 15 years
To help better understand one’s personal risk for lung cancer and the risks and benefits of screening, the University of Michigan has developed a decision aid. It is available at https://shouldiscreen.com.
Screening is most beneficial if it is performed yearly, and current data from the American Lung Association estimates that only 8 percent of patients who qualify for a screening get screened. In Michigan, only 23 percent of lung cancer cases are diagnosed at an early stage when treatment can be more successful and survival rates are higher. These two points underscore the importance of both physicians and patients being proactive in getting screenings completed. If we work together and use our tools and resources in the best ways possible, then we can all breathe a bit easier.
James Fenton, M.D., C.P.H.Q., is a board-certified, fellowship-trained thoracic surgeon with MyMichigan Health and a member of MyMichigan’s comprehensive cancer care team. As a thoracic surgeon, Dr. Fenton is dedicated to advanced and minimally invasive surgical management of a wide spectrum of thoracic conditions including disease of the lung, diaphragm, esophagus and the chest wall. He is dedicated to utilizing advanced surgical techniques, including robotic-assisted surgery, to improve quality outcomes and patient experience.
