Detecting lung cancer: UPMC opens new screening clinic after test proves effective
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Low-dose CT scans have proved to be an effective tool for early detection of lung cancer, the top killer cancer in the United States.
UPMC has opened a Lung Nodule Clinic offering low-dose helical CT scans to current and former heavy smokers to screen for lung cancer.
The clinic's opening followed the June 29 publication of results from the National Cancer Institute's National Lung Screening Trial in the New England Journal of Medicine affirming the effectiveness of the screening in detecting lung cancer early. Scientists found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with a CT vs. those screened by a chest X-ray. The trial, for which UPMC operated a test site, released preliminary results in November.
The screening is not yet covered by insurance, leaving patients to foot the $200 bill for the test at UPMC, which includes the CT scan, valet parking, and a group session with a nurse in which patients are urged to stop smoking.
Chris Faber, medical director of the UPMC Comprehensive Lung Center, of which the Lung Nodule Clinic is a part, expects that insurers will cover the screening within a year or two. New procedures or applications are never covered immediately -- insurance providers typically wait for organizations of medical specialists to make recommendations before offering coverage, he said.
Major organizations of specialists, including the American Cancer Society, the American Thoracic Society, the American College of Chest Physicians, and the American Lung Association are likely to issue clinical recommendations within a year or two. UPMC patients whose low-dose CT scans show abnormalities will typically receive follow-up CT scans, which are covered by insurance.
While radiation from a normal CT scan is significant -- equivalent to 80 chest X-rays -- the low-dose CT scan involves much less exposure -- equivalent to 15 chest X-rays. Determining if a lung nodule is cancerous or benign, however, ultimately requires a tissue biopsy.
Although the screening is effective at detecting lung cancer earlier than a chest X-ray, the test also generates a high number of false positive test results -- 97 percent in the NCI study. This means that many patients who test positive may undergo unnecessary follow-up CT screenings and surgical biopsies, potentially putting themselves at risk due to gratuitous radiation exposure or surgical lung biopsy.
First Published July 25, 2011 12:00 am
