Do you know that, if you are a current or former smoker, there is a test that is more likely to save your life than a yearly mammogram or a screening colonoscopy?
Of all malignancies, lung cancer is by far the biggest killer, causing more deaths than breast and colon cancer combined. Lung cancer is extremely difficult to treat and impossible to cure once it has spread beyond the lung. However, if detected early enough, it can be cured through surgery.
A low-dose chest CT scan is a quick, noninvasive test that detects lung cancer in its early stages when it can still be surgically resected. The scan itself lasts about a minute, involves safe levels of radiation exposure, and does not require intravenous access or lengthy preparation, such as that required for a colonoscopy. Most insurance plans pay the cost.
The National Lung Cancer Screening Trial, a large randomized study, found a 20% reduction in deaths in high risk patients who were screened with low-dose CTs.
This corresponds to one life saved for every 320 people scanned. In comparison, it takes 781 mammograms to prevent one breast cancer death, and 1250 screening colonoscopies to prevent one colon cancer death.
For this reason, the US Preventive Services Task Force recommends low-dose chest CT screening for the 14.6 million Americans who are at high risk for lung cancer. Nevertheless, only 6% of eligible Americans get a low-dose CT scan, while 70% of women undergo mammograms and 69% of eligible people complete colonoscopies.
Of all the states, Utah has the lowest smoking incidence of only 8%, much less than the national average of 14%. But Utahns who do smoke are near the bottom in compliance with the recommended screening CTs of the chest. In 2021, only 2% of eligible Utahns were scanned.
Why are so few high-risk Utahns getting screened for lung cancer?
For one, lung cancer screening is newer and less well known than other cancer screening programs. Some may believe that they have to quit smoking to participate in lung cancer screening, which is not true. Furthermore, among smokers, the prospect of the scan can give rise to feelings of fear, guilt and resignation.
We hope that, if you are a current or former smoker or if you know someone who is, you talk to a health care provider and learn more about lung cancer screening.
It may save your life or the life of someone you love.
Jessica Chan, MD, Emily Beck, MD, Peter Frech, MD, Salt Lake City
