2015 ASCO Educational Book - Screening for Lung Cancer, with Bernardo H.L. Goulart, MD, MS

October 13, 2015
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In this podcast, Dr. Bernardo Goulart discusses his article, "The Value of Lung Cancer CT Screening."



ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology known as ASCO, the world's leading professional organization for doctors that care for people with cancer.

This podcast is part of a series featuring articles from the 2015 ASCO Educational Book. Produced annually, the Educational Book is a collection of articles written by ASCO Annual Meeting faculty and leaders from ASCO's other meetings. Each volume highlights the most compelling research and developments across the multidisciplinary fields of oncology and serves as an enduring resource long after the meeting concludes.

In today's podcast, Dr. Bernardo Goulart discusses his article, “The Value of Lung Cancer CT Screening.” Dr. Goulart is a medical oncologist, an affiliate investigator in the clinical research division at the Fred Hutchinson Cancer Research Center in Seattle, Washington. In this podcast, Dr. Goulart explains how low-dose computed tomography or CT scans can be us to screen for early signs of lung cancer and people who may have a higher risk of lung cancer. ASCO would like to thank Dr. Goulart for discussing this topic.

Dr. Goulart: Hello, my name is Dr. Bernardo Goulart from the Fred Hutchinson Cancer Research Center. I'll be sharing some of the key points from my 2015 Educational Book article titled “The Value of Lung Cancer CT Screening: It is All About Implementation,” and I'll be talking about its implications for patients.

Let's first discuss what low-dose CT screening is and what it tries to achieve. Lung cancer is an important cause of suffering and death in United States because it is often detected at advanced stages when the disease is rarely curable. Lung cancer screening with low-dose CT is a test that uses low doses of radiation to generate the lung features that can detect lung cancers at earlier stages when cure is more likely to be achieved by surgery. Low-dose CT screening is a process that requires series scans over years. When low-dose CT detects an abnormality in the lungs, additional tests are usually necessary. Most of the times, these additional tests will consist of CT scans. But other tests are also possible, including more aggressive procedures such lung biopsies.

The main benefit of low-dose CT screening is that screened persons are less likely to die of lung cancer. In addition, those who undergo screening, who are actively smoking have the opportunity to quit smoking by engaging in effective smoking cessation treatments at the time of screening as guided by their doctors. By quitting smoking, persons will gain additional health benefits such as less cardiovascular disease and lung disease. Low-dose CT screening can cause a few harms. The most common harm caused by CT screening use the so called false positive result. This consists of lung abnormalities that are suspicious for lung cancer but turn out to represent benign findings. False positive results may lead to additional tests, and those can be a source of anxiety, increased healthcare costs, and discomfort. In addition, low-dose CT scans expose patients to some amounts of radiation. In theory, a risk exists that this radiation will cause an additional cancer in the lifetime of the patient. With that said, the amount of radiation used in low-dose CT scans is extremely small.

The benefits of low-dose CT scan far outweigh the risks imposed by radiation. Currently, commercial Medicare and Medicaid insurances aren't covering for low-dose CT screening in eligible patients. Patients should discuss with their doctors if they're eligible for a low-dose CT screening. Doctors will use several factors including age, smoking history, and other health factors to conclude whether a patient is eligible to proceed with low-dose CT screening. We encourage patients to discuss whether low-dose CT screening is indicated for them with their doctors, and we also encourage those who are smoking to ask their doctors about the available resources to quit smoking at the time of low-dose CT screening. Low-dose CT screening together with smoking cessation will reduce by a large amount the number of deaths and suffering caused by lung cancer. For additional information, please view my article online at asco.org/edbook for a more in-depth discussion of this topic. Thank you.

ASCO: Thank you, Dr. Goulart. Please visit asco.org/edbook to read the full article or visit www.cancer.net/lung for a comprehensive guide to lung cancer.

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