It’s known as cancer’s silent killer. Lung cancer remains the deadliest of cancers because it often goes unnoticed until it reaches advanced – and incurable – stages. For about sixty years, researchers sought a screening for lung cancer that would detect it early enough to treat and maybe even to cure.
That lung cancer screening is finally here – and it’s been such a success at Atrium Health that it’s already received national recognition and started conversations about what this might mean for the future of lung cancer.
The National Lung Screening Trial in 2011 revealed that a low-dose CT scan can detect a lung tumor at a much earlier stage than a chest x-ray can. Subsequent tests proved what a difference that early detection makes: Patients screened annually with low-dose CT have twice the odds of receiving a more treatable Stage 1 lung cancer diagnosis than those who do so with a chest x-ray. Four years later, Medicare began to cover these scans for eligible patients, making them widely affordable and accessible to people who need them most.
Just as people can be screened annually for breast, prostate or colon cancer, people at risk of lung cancer can now be screened annually for that, too. The possibility this screening brings to the treatment of lung cancer is significant. The five-year survival rates for breast, prostate and colon cancers – the ones most commonly screened – have risen to percentages into the 90s for breast and prostate, and into the mid-60s for colon. For decades, the five-year survival rate for lung cancer has remained stagnant at about 18 percent. But that may soon change.
“It’s an exciting time to treat these patients,” says John Doty, MD, a pulmonologist and the physician leader of Atrium Health’s lung cancer screening initiative. “The best chance to cure lung cancer is to find it early enough that it can be surgically resected. My hope is that as we do more screening, we’ll find more early-stage cancers.”
A quick process, a lasting impact
Johnnie McGuire, 71, was among the first people screened for lung cancer through Atrium Health’s program. Her primary care doctor, Leigh Cicci, MD, knew that Johnnie was a longtime smoker, and during a routine appointment, Dr. Cicci recommended the screening. Johnnie agreed.
Things moved quickly after that, Johnnie says. She went in for her screening, tested positive for Stage 1 lung cancer, and had surgery to remove it. Within two months of the conversation that Dr. Cicci and Johnnie shared during a regular visit, Johnnie was cancer-free and back at home.
“I wouldn’t have known about the lung cancer screening unless Dr. Cicci told me about it, that there was a new screening that would catch it before it proceeded to a later stage,” Johnnie says. Years earlier, Johnnie helped her father through advanced-stage lung cancer, and she remembers how difficult the experience was for him before he died. The possibility of detecting lung cancer in its early stages appealed to her.
“I now tell my friends, there’s nothing to this screening,” she says. “There’s a lot of cancer out there, and hopefully doing this can give people many more years.”
It’s been one year since Johnnie received her cancer diagnosis. After 55 years of smoking, she hasn’t smoked a cigarette since her surgery. She remains cancer-free.
Serving those most at risk for lung cancer
The screening is available to people between the ages of 55 and 77 who have no symptoms of lung cancer. Patients must be current smokers or have quit smoking within the past 15 years, and must have at least a 30 pack-year smoking history. This could mean 30 years of smoking one pack per day, 15 years of smoking two packs per day, or 60 years of smoking half a pack per day.
Atrium Health has instituted a system that alerts primary care providers to patients who may be eligible for the screening. A health maintenance alert in a patient’s medical record reminds the doctor to begin the conversation, just as Dr. Cicci did with Johnnie.
“Some patients will tell me that they don’t need the screening because they’re not having any symptoms,” Dr. Cicci says. “But then we talk about wanting to catch lung cancer before they do have any symptoms, and if we do, that we might be able to cure it. Then they’re very much on board.”
If patients meet the eligibility criteria, they’ll have a shared decision-making conversation with their provider. Diane Merrill, MSN, ACNP-BC of NorthEast Lung Associates had that discussion with Johnnie, as she does with many other patients, to help her understand the risks and benefits of the screening. Most eligible people, once they learn of the screening, decide to proceed.
Atrium Health’s screening process has already captured national attention. It has earned the Screening Center of Excellence designation by the Lung Cancer Alliance, which honors centers that offer high-quality, safe screenings to the community.
So far, about 2,200 patients have been screened. Among those patients, several early-stage cancers have been found.
The outcomes should only improve as more people enter the screening program and get screened each year. Dr. Doty hopes that in time, the five-year survival rate will finally begin to improve, ending decades of stagnation.
Could you be eligible for a lung cancer screening? Let us help you with your next steps. Talk to your provider, or call us at 704-302-9203 to make an appointment. To learn more, visit AtriumHealth.org/LungCancer.
