Lung Cancer Screening
Lung cancer has been the top cancer killer for decades. Up to 80% of lung cancer patients are found to be in advanced lung cancer upon diagnosis. Lung cancer is a silent killer and it does not produce any symptom till late stage. The only way to decrease the mortality is by early detection and early curative surgery.
What is the best mode of lung cancer screening?
Chest X-ray and sputum screening have both been proven to have no benefit in decreasing risk of dying from lung cancer. The only screening tool of value to reduce lung cancer related mortality is Low Dose Radiation Non Contrast CT thorax. As it involves small dose of radiation compared to standard CT scan and is without contrast, the risk is marginal and is well accepted by general population.
Who should go for the lung cancer screening?
Lung cancer can happen in any age and gender. There is no optimal age to start screening. However, for smokers who have been smoking or smoked within the past 15 years and those who have a family history of lung cancer, early screening is recommended.
Where should it be done?
It is important to have it done at a medical center with special expertise in lung cancer screening and most importantly, able to offer appropriate treatment and advice with regard to abnormal CT findings.
What should be done if CT scan shows abnormal result?
Usually, abnormal result means there is nodule(s) in the lung or mediastinum (chest). Lung cancer has certain characteristics and will be recognized by experienced doctors.
Depending on the characteristics of the nodule and the patient’s general condition, the doctor will then offer either of the following options:
- Observation with repeat scan in the future– for nodules that appear benign
- CT guided needle biopsy
- Bronchoscopy evaluation +/- biopsy – usually for central tumor
- Video-assisted thoracoscopic biopsy – usually offered for nodules that may be cancer and with the view to curative resection should it proves to be malignant during the surgery
The different options will be discussed with patients for an individualistic and most appropriate management plan.