WHYY story on lung cancer screening

For smokers worried about lung cancer, the first--and most important--advice is always: stop smoking.

But now, some doctors are also recommending an initial screening test using a low-dose spiral CAT scan.

Lung specialist Mani Kavuru directs the Division of Pulmonary and Critical Care Medicine at Thomas Jefferson University Hospital, which just began offering the screening test.

Kavuru says lung cancer kills more people than any other cancer.

"There's been this nagging feeling that we ought to be able to make progress by finding cancers early," Kavuru said.

A National Cancer Institute study, released this summer, found that low-dose spiral CAT scans cut cancer deaths 20 percent, compared to a traditional chest X-ray.

The study participants were current and former heavy smokers age 55 to 74.

"This is hotly discussed and debated among the specialists, the experts feel that it's a major breakthrough in early detection," Kavuru said.

A CAT scan uses radiation, so experts say the potential benefit for a patient has to outweigh that risk.

The screening is not covered by health insurance, but Jefferson Hospital offers it as part of package deal including the test, interpretation, consultation with specialists and stop-smoking counseling.

Dr. Norman Edelman is chief medical officer at the American Lung Association.

"Three hundred fifty dollars for what they are offering, that sounds very, very reasonable, so one would wonder why it's priced at this level," Edelman said. "Of course I can't give you the answer, but in general, one has to be aware that it is not only the use of the CAT scanner, but it might be subsequent surgery or subsequent procedures of other kinds that will take place at the medical center," he said.

The Lung Association is developing guidelines to help patients discuss the screening decision with their doctor.

"There should be an intelligent conversation that happens between a patient and a health care provider," Kavuru said. "This is not just for people who just want to know, this is for people at the highest risk of lung cancer."

Published: 11-28-2011

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