Lung cancer screening guidelines could save thousands of lives

Michael Weyant, MD, is a specialty care physician board-certified in thoracic surgery and general surgery who has special expertise in robotic minimally invasive surgery, lung cancer and thoracic surgery. He joined Inova Health System as the system-wide director of the thoracic surgery program in 2021 and has been practicing surgery since 1996.

Lung cancer is the deadliest disease in the US, killing an estimated 130,000 Americans each year — more than breast, prostate and colorectal cancer combined. The five-year survival rate for lung cancer hovers around 28 percent. These sobering statistics are due, in part, to low screening rates among high-risk individuals.

“Lung cancer is hard to cure, but patients have the best chance for a positive outcome when we find it in its early stages,” says Michael Weyant, MD, a thoracic and general surgeon at Inova. “That’s what we get from screening.”

In 2021, expanded screening recommendations issued by the United States Preventive Services Task Force (USPSTF) dramatically changed the lung cancer landscape for individuals at the highest risk of developing the disease.

Lung Cancer Screening Recommendations

In a landmark 2011 study, researchers found that people who were screened for lung cancer with an annual low-dose computed tomography (CT) scan had a 20 percent lower risk of dying from lung cancer compared to those who were screened with chest X-rays.Doctors also tended to find tumors at earlier stages among those in the low-dose CT group. Two years later, U.S. Preventive Services Task Force issued practice guidelines encouraging current and former smokers who smoked a pack of cigarettes a day for 30 years to get screened for lung cancer with low-dose CT starting at age 55.

“What changed in 2021 is that new data found we get the same benefit of truly saving lives by screening people 50 to 80 years old with a 20-pack-year history or more of smoking,” Dr. Weyant says. The revised guidelines nearly double the number of Americans eligible for screening, including more women and Black Americans.

The USPSTF’s 2021 guidelines recommend low-dose CT screening for people who meet these criteria:

• Have smoked the equivalent of 20 “pack years” (one pack a day for 20 years), and
• Are either current smokers or stopped smoking within the past 15 years, and
• Are between ages 50 and 80 years old

Lung Cancer Screening Concerns

Lung cancer screening is complicated. While a low-dose CT takes only minutes to complete, not every hospital is equipped with the necessary technology. Plus, screening may uncover incidental findings that require further, often invasive, testing.

“When we start scanning people, we occasionally see lesions or abnormalities that look like cancer, but aren’t,” Dr. Weyant says. That results in a cost to patients in terms of the stress, anxiety and inconvenience of investigating harmless nodules.

Overall, the data from large population studies show that number of lives saved far exceeds those inconvenienced by unnecessary procedures. In addition, uncovering other conditions, such as chronic obstructive pulmonary disease, emphysema and heart disease, can be a significant benefit for patients.

Lung Cancer Screening Made Easy

It’s important to make sure your primary care provider knows your smoking history and that it’s part of your electronic medical record. With that information, your provider will receive a notification through the system to order a low-dose CT screening exam if you qualify.

Most insurance companies cover annual low-dose CT screening for individuals who meet the criteria.

“Don’t be afraid to ask your health care provider to review the eligibility criteria with you to determine whether you’re a candidate,” Dr. Weyant says. “If we can find and treat lung cancer in its earliest stages, we can save thousands of lives.”

Learn more about the Inova Lung Cancer Screening Program or call 571-472-3500 to schedule an appointment.