Re: “A challenge to managed health care,” April 22 Colorado Voices column.
This commentary highlighted the profound benefits of early detection of lung cancer. Most patients with lung cancer are diagnosed only when they experience symptoms from spreading, incurable cancer. As a result, more than half of lung cancer patients die within one year of diagnosis. If lung cancer is diagnosed at an early stage, five-year survival increases from 17 percent to between 70 and 80 percent.
Unfortunately, there are no signs or symptoms of early-stage lung cancer. The nodule on Richard Stacy’s lung was detected largely by chance, on a CT scan ordered for another respiratory problem.
Our Lung Nodule Registry, a unique, automated tool developed at National Jewish Health, analyzed the radiologist’s report, and automatically alerted his physician to ensure a timely follow-up scan. When that scan showed that the nodule had grown, it was surgically removed. Stacy now appears to be cancer-free.
As Stacy points out, a broader use of imaging, electronic health records, and automated reporting systems could reduce lung cancer deaths. However, we cannot and should not screen every person in the United States for lung cancer as cost, radiation exposure and occasional false alarms have to be considered. Who, then, should be screened?
A landmark study in 2011 demonstrated that yearly CT screening of high-risk individuals, 55 to 75 years old, who have smoked the equivalent of a pack of cigarettes a day for 30 years reduced lung cancer deaths by 20 percent. The American health care system is greatly expanding access to lung cancer screening and smoking cessation. Private insurers now pay for screening of high-risk individuals. Medicare is implementing a similar program.
We encourage everyone at high risk for lung cancer to undergo screening at National Jewish Health or at any of several other centers in Colorado. Early detection can save lives.
Debra Dyer is chair of the Department of Radiology and James Jett is a professor of medicine at National Jewish Health.
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