Tuesday, January 13, 2015

Screening for Lung Cancer

Testing individuals who appear to be healthy for signs of a particular disease is called screening. The hope is to find the disease before it has caused undue harm and while it can still be treated. But when the disease is not common or the screening test is expensive, it's simply not cost effective to screen everyone. That's why epidemiologists and health professionals try to develop screening guidelines that focus sub-populations of the population that are at the highest risk. By screening only those most likely to have or get the disease or condition, expensive screening tests DO become cost-effective, at least for that specific group.

So, how about screening for lung cancer? The best test for detecting lung tumors while they are still small enough to be treated is low-dose computed tomography (LDCT). The test is expensive, so screening everyone just isn't practical. That's where the U.S. Preventive Services Task Force USPSTF comes in. The task force is charged with determining which screening tests should be made available to whom, based on a risk/benefit analysis. In 2014 the USPSTF revised their screening recommendations for lung cancer. Under the new guidelines, annual LDCT screening for lung cancer is now recommended for all persons aged 55-80 who have a 30 pack-year history and who are still smoking or have quit within the past 15 years. In 2008, over 7 million U.S. adults were 30- pack-year smokers! Screening all smokers in this high-risk group every year could save more than 20,000 lives per year.

For your information, "pack-years" is the product of packs smoked per day times years smoked. A thirty pack-year smoker has smoked at least a pack a day for 30 years, or two packs a day for 15 years, or three packs a day for 10 years....you get the idea. If you're not a 30 pack-year smoker you aren't eligible for this screening, meaning that your medical insurance probably won't pay for it.

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