Lung Cancer Screening

The lung cancer screening program at EvergreenHealth is helping catch lung cancer at its earliest, most treatable stage.

It's increasing survival rates far beyond other detection methods. Often lung cancer isn't caught until your doctor orders a chest X-ray if you have symptoms that might be bronchitis or pneumonia. But by the time a mass or nodule shows up on an X-ray, your lung cancer is already likely past the early easily-curable stage.

What is lung cancer screening?

Lung cancer screening is a diagnostic imaging method which uses a small amount of radiation to detect early-stage lung cancer. The screening is performed with a low-dose computed tomography scan (CT scan), and may be recommended on an annual basis by your provider.

Who is eligible for the lung cancer screening program?

Most medical experts, along with the American Thoracic Society and the United States Preventative Task Force, recommend talking to your provider about lung cancer screening if you meet ALL THREE of the following criteria;

• You are between the ages of 50-77
• You currently smoke or quit smoking less than 15 years ago.
• Your "pack-year" number is greater than or equal to 20. To calculate your pack-year number, multiply the number of years you smoked by the average number of packs (1 pack = 20 cigarettes) you smoked per day.

The following symptoms and criteria may disqualify you from the lung cancer screening program, but it is very important to discuss them with your healthcare provider.

• a new cough that will not go away.
• a change in your chronic cough.
• losing weight without trying.
• coughing up blood.

What are the benefits of lung cancer screening?

Lung cancer screening has proven to be a beneficial tool in early detection and treatment of the disease. In a study of over 50,000 patients conducted by the National Lung Cancer Screening Trial (NLST), there was a 20% lower death rate for patients screened with the low-dose CT scan. The study concluded that for each group of one thousand patients who underwent lung cancer screening, 3 lives were saved.

Can lung cancer screening cause any harm?

EvergreenHealth's goal is to provide lung cancer screening for patients only when the benefits outweigh the potential harms. Although lung cancer screening has been proven to be beneficial overall, there are some associated risks;

• During the National Lung Cancer Screening Trial (NLST), an average of 3 in 1,000 patients had a major complication from an invasive procedure.
• An average of 25% of patients who had annual screening had an abnormal finding. 95% of findings were proven to be non-cancerous upon further testing which is referred to as a "false positive." There are times when a false positive can lead to additional testing such as a follow-up CT scan or in rare cases, biopsy.
• A screening CT scan uses a low dose of radiation to create the image. The amount of radiation used depends on the person's body size, but for most patients is less than one third of the amount used in a regular CT scan. Please talk with your doctor if you have concerns about the radiation involved in the screening.
• Some patients experience an increase in stress and anxiety related to lung cancer screening and test results.

Is lung cancer screening covered by insurance?

Most insurance plans cover lung cancer screening, but it is always a good idea to call your insurance company to confirm your benefits.

How does EvergreenHealth's lung cancer screening program work?

Step 1. If you meet the screening criteria, your provider will send a referral to the lung cancer screening program located within EvergreenHealth's Pulmonary Care Center.

Step 2. A staff member from the Pulmonary Care Center will contact you within a week to confirm the screening criteria and schedule a mandatory initial appointment called a "shared decision making visit".

Step 3. During your shared decision-making visit, a Pulmonary Care Center provider (lung specialist) will discuss a plan for your care and a staff member will assist you in scheduling a CT scan.

Step 4. After your scheduled CT scan, the results will be read by a radiologist and reviewed by a provider in the Pulmonary Care Center. The results will also be sent to your primary care provider within ten days of your CT scan.

Step 5. The Pulmonary Care Center will contact you if there are any areas of concern seen in your lungs. If your results are normal, you will receive a letter regarding any recommended follow-up care.

Please Note: If you are a current smoker, keep in mind that enrolling in the lung screening program is not a reason to keep smoking. A provider can refer you to EvergreenHealth's smoking cessation clinic and/or provide you with strategies to help you quit. Even if you chose not to participate in the program or are not eligible, EvergreenHealth can partner with you to help reduce your risk of cancer through preventative healthcare and helping you make healthy lifestyle choices.

How do I start the lung cancer screening program?

You can ask your primary care provider about a referral to the program or call the EvergreenHealth Pulmonary Care Center at (425) 899-6972 for more information.