As we look ahead at welcome changes happening in screening for lung cancer it is helpful to look at the numbers. When we do, it’s hard to understand why anyone would smoke: 1 in 5 deaths in the United States are related to the use of tobacco. More than 158,000 Americans will be lost to lung cancer this year, and 87% of them are due to tobacco. Staggering evidence has been in front of us since the 1960’s. And yet we continue to use tobacco, though in slowly dwindling numbers. If we eliminated the use of tobacco we would cut lung cancer deaths to the core.
Lung cancer is a silent threat to those that use or have used tobacco, to those exposed to radon in the home, and those exposed to asbestos and certain chemicals or metals in the workplace. Yes, there are other causes of lung cancer plus one we’re not sure of yet, though evidence is mounting: the use of e-cigarettes or vaping. I think of lung cancer as a silent killer because it begins simply, possibly from a tiny scar or lesion in the delicate lining of the lungs or bronchi, and grows without hindrance and without symptoms. Often, by the time there are symptoms, lung cancer is locally advanced or may have spread making treatment more difficult.
We now use protective gear provided in the workplace that’s proven to save lives. We know that radon is present in soils containing uranium like ours here in central Wisconsin and having basement air checked is easy to do with home test kits available at hardware and home stores. We know that tobacco presents the biggest threat to our health taking more lives each year than colon, prostate and breast cancer combined.
In the past, screening for lung cancer was not based on science. X-rays and sputum tests could be requested by a patient but were not reliable. Screening had no real guidelines and that meant that patients were symptomatic by the time they were diagnosed. At Turville Bay we know that finding and treating lung cancers before symptoms occur means a better chance of a good outcome.
Finally, a study underway since 2001 involving thousands of individuals has produced compelling data. It found that heavy tobacco users who got low-dose CT scans had a 20% lower chance of dying from lung cancer than those who got chest X-rays. The evidence was so powerful that Medicare, Medicaid and many insurance companies will now cover annual low-dose CT screening for those that meet certain criteria:
- Adults aged 55-80
- Having smoked a pack a day for 30 years or the equivalent in 15 years
- Currently smoke or quit within the last 15 years
- Have a physician’s order requesting the screening
Protocals are coming to our local clinics. Soon we hope to see the death rate from lung cancer in our population reduced. No, these long awaited screening guidelines are not going to solve the problem. But it’s a start. My message? Take control over your health. Quit tobacco and embrace a healthy lifestyle. You’ll breathe easier. We all will.