Lung Cancer Screening & Prevention

Screening for Lung Cancer

Many individuals have a family history of lung disease, or have been exposed to substances such as smoke, asbestos, or even dust from the World Trade Center. It is important that they receive screening for lung diseases, and after initial screening, that any abnormalities are followed up appropriately. Lung cancer screening with computed tomography (CT) helps to detect lung cancer at an early stage when it can be removed completely and cured.

Lung Tumor Screening

The challenge facing patients and their physicians lies in the fact that there is a good chance that a nodule will be found in the lungs, especially in patients over 55 with a history of smoking. In most cases, the nodules are eventually determined to be harmless — but many patients will experience weeks or months of anxiety until a diagnosis is established. In addition, differences in the ways that physicians manage the care of patients with nodules can make the follow-up process very challenging for both patients and their physicians.

On the other hand, it is not uncommon for a patient to have a CT scan for another reason that detects a lung tumor incidentally. Because some tumors do spread and become deadly, assessment and monitoring of any suspicious lesion is critical. Abnormalities must be monitored diligently so that lesions requiring intervention can be treated earlier rather than later. The High-Risk Lung Assessment Program at NewYork-Presbyterian/Columbia University Medical Center has established a highly refined process to do this in a very efficient manner.

We recommend CT screening for people who have a high risk of lung cancer based on their age and smoking history. Based on the guidelines used in the large NIH sponsored multi-institutional study, patients at high risk for lung cancer include those between ages 55 and 74, who have are either current or former smokers with a smoking history of 30 pack years or more, and who are able to undergo surgical therapy should a pulmonary nodule be detected on screening CT scan. Although not established by this study, patients with a lesser history of smoking but with a family history of lung cancer or asbestos exposure should also consider a screening CT scan. For those with a moderate risk, thorough discussion of the potential results of a scan and follow-up options is essential before deciding upon screening.

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