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Lung Cancer: CT Screening for Early Detection
By Robert Kanterman, MD

Lung cancer is the second most diagnosed cancer in both women and men, and the leading cause of cancer death in the country. It also accounts for 30 percent of all cancer deaths in America. Nationally, the five year survival rate is less than 16 percent which continues to be substantially lower than other major cancers such as breast, colon and prostate cancers.

Improved detection of lung cancer at earlier stages, when the lung cancer is much more easily treated, is the key to improved survival. In response to this need, a joint body of St. Luke's Hospital physicians met to discuss the use of low-dose computed tomography (CT) scans to screen high-risk patients for lung cancer. These physicians include representatives from pulmonology, cardiothoracic surgery, medical oncology, radiation oncology and radiology. This body has recommended implementation of lung cancer screening for high-risk patients with low-dose CT scans. This program launched in the Fall of 2012 at St. Luke's Hospital.

Publications in major medical journals, including The Journal of the American Medical Association (JAMA) and the New England Journal of Medicine, have validated the test, and specialty physician and medical organizations (American College of Chest Physicians, American Society of Clinical Oncology, the National Comprehensive Cancer Network, et al) are recommending this test for high-risk individuals. Screening has been shown to reduce deaths from lung cancer by 20 percent and has also reduced overall mortality by 27 percent in a large, multi-center prospective trial.

Screening Criteria
Low-dose CT screening is recommended for the following:
  • Current or former smokers between the ages of 55 and 74 years
  • A smoking history of at least 30 pack-years (this means one pack a day for 30 years; 2 packs a day for 15 years; etc.)
  • No history of lung cancer
If you are in this group, you are at the highest risk for lung cancer and screening is recommended for you. Talk to your physician about getting a CT scan to screen for lung cancer.

In most cases, third party payers are not providing reimbursement for the initial screening, so this test will be offered as a self-pay exam, unless otherwise pre-approved by insurance providers. The results of this examination will be coordinated by the radiology department with in put from the pulmonary physicians. Appropriate referrals to St. Luke's pulmonologists, oncologists and thoracic surgeons will follow. Dr. Robert Kanterman and Dr. Robert Ryerson are the co-managers of the screening examinations in the department of radiology. Patients may call Radiology Scheduling at 314-205-6565 to schedule an appointment. Physician referral is not required.

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