What Doctors Want Patients to Know About Lung Cancer Screening

Lung cancer causes approximately 160,000 deaths annually in the United States. That’s more than the next three most common cancers (colon, breast, and prostate) combined. However, only about 30% of lung cancer cases are diagnosed early, and most patients are diagnosed at a later stage, which is much more difficult to treat.and about 20% of lung cancer deaths are preventableevidence-based screening recommendations for high-risk patients offer the best hope for early detection of disease and the best chance of effective treatment.

AMA policy recommendations Lung cancer screening is considered standard of care Medicare, Medicaid, and private insurance coverage for screening low-dose computed tomography (CT) scans for patients at high risk of lung cancer are also mandatory coverages. The policy also aims to raise awareness of lung cancer screening with low-dose CT scans in high-risk patients, improve screening rates, and reduce the leading cause of cancer death in the United States.

of the AMAs What doctors want their patients to know™ series provides a platform for physicians to share what they want their patients to understand about today’s healthcare headlines.

In this article, AMA member Omar Atiq, MD, medical oncologist at the Winthrop P. Rockefeller Cancer Institute at the College of Medicine of Arkansas, Little Rock, and president-elect of the American Medical Association, took the time to discuss: need to know about lung cancer screening and prevention.

“In general, anyone can get cancer based on many different factors, but the most preventable cause of cancer death is smoking.” Dr. Attic“It’s cigarette smoking, pipe smoking, cigar smoking. Mostly cigarette smoking in our country.”

“Are there other risk factors? Yes,” he said. “There are environmental factors, such as exposure to heavy metals such as arsenic, lead, and uranium, and air pollution, but they are not as clearly defined risk factors as smoking and tobacco, so screening guidelines are based on cigarette smoking. .”

“I don’t know yet whether e-cigarette, e-cigarette Or even marijuana is associated with an increased risk of lung cancer,” Dr. Atiq said.

“Due to the effects of smoking, Recommendations from the U.S. Preventive Services Task Force People between the ages of 50 and 80 who have smoked 20 packs should be screened annually with a low-dose CT scan,” explained Dr. Atiq. “Well, what does 20-year pack history mean?

“So if someone smokes two packs of cigarettes a day for 10 years, that’s 20 packs of history,” he added. “On the other hand, people who smoke one pack of cigarettes a day for 20 years are thought to have 20 years’ worth of smoking history and cause similar lung cancer risks.”

“A history of ≥20 packs between the ages of 50 and 80 years, current smoker or quit within the last 15 years, asymptomatic and otherwise healthy, able to tolerate treatment. It needs to be someone who can do it, if lung cancer is found,” Dr. Atiq repeated. “If you have smoked 20 packs, are 60 years old, and quit 20 years ago, your risk of developing lung cancer is generally lower than for people who smoke now or quit within the last year. It’s been considered for the past 15 years.”

“An annual low-dose CT scan is recommended for patients aged 50 to 80 years who have a history of smoking 20 packs and who currently smoke or have quit within the past 15 years,” said Atiq. says the doctor. “Low-dose CT scans are advanced he CT scanners and do not get the full dose of radiation that you get with diagnostic CT scans.

“But if a radiologist can get enough images to be able to find small lung cancers,” he added. is considered inadequate for

“Low dose CT scan screening for lung cancer You have to have the right equipment in the right place, the right radiologist and the right follow-up,” said Dr. Atiq. “In other words, proper medical care that has the right equipment, knows what they’re doing, and knows that if lung cancer is found, or for that matter, the patient is getting proper follow-up.” Team should be placed.Other malignancies or other diseases.

“Follow-up includes seeing if there are any abnormalities. Radiologists will sometimes ask what their suspicion is in terms of this abnormality in the lung being lung cancer or some other disease. “Then your GP or pulmonologist may need to do more tests to confirm that it’s actually lung cancer,” he explained.

“If lung cancer is confirmed, a proper workup for further management will be required, which I hope includes surgical resection,” said Dr. Atiq. “This means that you will get early-stage lung cancer, but screening can also find advanced cancer.

“For them, we may need a multidisciplinary team that includes medical oncologists, radiation oncologists, and surgical oncologists,” he added. It’s the right way to use it.”

“Lung cancer screening has several risks. One is that we may find abnormalities that require further testing, which may ultimately turn out not to be cancer,” says Atiq. “However, further testing complications may occur. The biopsy, if undetected, would not have affected the patient’s longevity or quality,” said Dr. We may be able to find small cancers.”

In turn, it says, “You’re treating something that doesn’t need to be treated. Repeated low-dose CT scans could theoretically cause cancer in some people. However, the risk is very low,” he said. “Therefore, the risks and benefits must be weighed for individual patients.

“However, the U.S. Preventive Services Task Force, the Centers for Disease Control and Prevention, the American Cancer Society, and other lung cancer experts generally agree that lung cancer screening has been shown to reduce mortality in appropriate populations. I do,” said Dr. . Atiq. “Many of them can be found in the early, potentially curable stages, rather than in the advanced stages, which are symptomatic and incurable.”

“People shouldn’t smoke because smoking is the most common and most prominent preventable cause of cancer death,” urged Dr. Atiq. “If they smoke, they should. quit smoking. It is beneficial.

“Talk to your doctor about: no smoking,” he said. Whether you just started smoking or have been smoking for five or ten years or more, you should always do so if you smoke. even if it has not reached

“Exposure to asbestos is now rare, but based on what we know about the relationship between asbestos and cancer, we know that asbestos can lead to lung cancer,” Dr. Atiq said. “Then the environment. We have to look after our environment. We have to reduce pollution.

“We should ensure that people exposed to heavy metals and other contaminants have appropriate clothing, masks, goggles, protective equipment and equipment to minimize their exposure to those elements. “And while the data is still inconclusive, it does tell us that, logically, marijuana should also be avoided.” Electronic Cigarette There are good reasons to believe that e-cigarettes can also have detrimental health effects, especially when it comes to cancer. ”

“If you are between the ages of 50 and 80 and have ever smoked or currently smoke, you should talk to your doctor,” says Dr. Atiq. “But in general, primary care physicians, internists, family physicians, etc., generally bring this up on their own, as long as the patient has a relationship and follows up with that physician.

“It’s the only way,” he said, adding, “The highest honor and highest privilege is to be a doctor when a stranger puts his life in your hands.” So without complete honesty and transparency, the relationship can be damaged, and there is no reason for it.

“Doctors can’t help patients if they don’t tell them everything,” emphasized Dr. Atiq. “So if we don’t know you smoke, we can’t serve you properly. no smoking and for lung cancer screening. “

“By minimizing exposure to known carcinogens and by using appropriate screening to prevent cancer, the risk of dying from lung cancer can be reduced,” said Dr. Atiq. “This is a very personal decision and screening should be recommended unless the physician and patient have reason to believe that the benefits of screening do not outweigh the risks.

“Lung cancer is preventable, and an ounce of prevention is better than a pound of cure, so don’t smoke. If you smoke, quit,” he said. “Also, try to keep your environment clean of pollutants. It’s a social responsibility, of course, but we all, as individuals, have an important role to play in shaping society.

“If you have questions, ask your doctor,” he stressed. “What we are doing at the American Medical Association, the largest umbrella organization of physicians in our country, is to help our members, the general public and our patients live longer and better lives.”