Nav: Home

Free lung-cancer screening in the Augusta area finds more than double the cancer rate of previous screenings

March 09, 2017

AUGUSTA, Ga. (March 9, 2017) - The first year of free lung cancer screening in the Augusta, Georgia area found more than double the rate seen in a previous large, national study as well as a Massachusetts-based screening for this number one cancer killer.

The higher rates, coupled with the majority of cases being found in early, treatable stages, point toward the need for ongoing, accessible free screening in high-risk populations and underserved regions, say researchers at the Georgia Cancer Center at Augusta University. High risk includes those who have smoked a pack of cigarettes daily for two or three decades and, if they've quit smoking, did so less than 15 years ago.

The screening of 264 high-risk individuals within a 150-mile radius of Augusta found 3 percent had lung cancer and 75 percent of those were caught early, said Dr. Carsten Schroeder, thoracic oncology surgeon at the Georgia Cancer Center and Medical College of Georgia at AU. The researchers note that a percentage of the patients presenting at screening had early symptoms, like a persistent cough, so the rate of cancer detection in patients who showed no indication of disease was 2.2 percent, still double the rates of previous studies.

"Lung cancer is still the number one cancer killer in the United States and in our world," Schroeder said. "If we catch it in the early stages, ideally before symptoms surface, we can operate and patients can have an overall survival rate of 90 percent." Five-year survival rates are closer to 5 percent in more advanced disease.

The pioneering National Lung Screening Trial, which began in 2002 and included 33 largely urban centers, found 292 cases of lung cancer among the 26,722 high-risk individuals screened in the first year, for a rate of 1.1 percent. That study also provided the first broad evidence that low-dose computed tomography, or LDCT, was a more effective screening tool than the traditional chest X-ray. A decade later, the Massachusetts-based Lahey Hospital & Medical Center, on which the Augusta screening was modeled, found a .6 percent prevalence in the first 10 months of screening.

Like the previous experiences, the Augusta area screening that started in 2014, also reiterated the ability of LDCT to find lung cancer early, said Schroeder, corresponding author of the study in Southern Medical Journal.

Six of the eight cases found in the screening were considered potentially curable with surgery. Positive results were communicated directly to the participant's primary care provider; negative results were communicated to primary care docs and participants, along with a reminder for another screening in a year.

Participants, particularly from surrounding, more rural communities, have limited access to health care, Schroeder said. The area's median household income is 27 percent lower than the national average and the poverty level is 67 percent higher, according to the U.S. Census Bureau. The Augusta-area experience found generally younger patients, who started smoking earlier in life and had multiple risk factors. Augusta area participants were an average of 60 years old, about half male and female, more than 68 percent were white and nearly 20 percent were black.

"It doesn't matter how old you are, if you have smoked 30 years, you might want to consider a lung-cancer screening," Schroeder said, referencing the reality that some adults started smoking as children. Part of his drive to start a screening program in the Augusta area was that, when he relocated here three years ago from the Cleveland area, he found patients were often referred to him with later, less-treatable disease. In the Cleveland area where Schroeder previously practiced as a faculty member at Case Western Reserve University and where access to health care and/or health insurance was more widely available, early lung cancers might even be detected incidentally when patients had CT scans for a variety of other reasons.

Augusta researchers were able to offer free screening by utilizing natural downtime of the combined positive emission tomography, or PET, and computed tomography, or CT, scanner, said Dr. Norman B. Thomson III, chief of general/cardiothoracic radiology in the MCG Department of Radiology and Imaging and study co-author.

The combination technology is often used to visualize other tumor types throughout the body and many patients require an injection of sugar dye, which will be taken up by the tumor but must first circulate for about an hour before the scan is done. That means the machine is staffed at times when it is not able to be fully used for other diagnostic procedures, time that provides a natural window for lung screening using just the CT imaging capability in under five minutes from arrival to exit, Thomson said. More typically, a scan could cost between $100-$250.

In the last decade, CT technology has gotten increasingly adept at picking up early, small nodules, Thomson said. Low radiation doses work well in the lungs, which are mostly filled with air that provides a blank background for nodule surveillance. Thomson notes that means LDCT is also adept at finding things like scar tissue and small inflammatory nodules, that also are more common in the lungs of smokers. Nodules a third of an inch or smaller tend not to be cancer and more solid masses tend to be, Thomson said. They may follow up on smaller nodules in six months, then if the nodule is stable, go back to annual reviews.

And while some lung cancers are super aggressive, screening also may uncover some slow-growing versions that - like some prostate cancers - will not threaten life but need to be treated and/or closely followed once found.

"That's why the acid test for screening is not how many cancers you find or what stage the cancer is," Thomson said, rather what screening does to lung cancer death rates. Current evidence definitely supports screening, he said. Also, like lung cancer has been coincidently found in CT scans for other reasons, physicians like Thomson and Schroeder are now incidentally finding cardiovascular disease in their lung cancer screening.

To date about 700 individuals have been screened in the Augusta area and Schroeder is working to expand statewide, hoping to use the state public medical school's extensive campus network that has students learning from physicians at practices and hospitals across Georgia, as a natural base.

"We want to reach as many people as we can as early as we can," he said. Also, about half of patients screened continue to smoke so screening might also be a logical point for smoking intervention, Schroeder said.

The original National Lung Screening Trial, orchestrated by the National Cancer Institute and the American College of Radiology, was launched in 2002 and enrolled nearly 54,000 patients nationally. Five-year survival rates were about 70 percent for early cancers and about 5 percent for lung cancer found late.

Following the trial, the National Comprehensive Cancer Network, a nonprofit organization of cancer centers that develop guidelines for cancer diagnosis and treatment, along with the United States Preventive Services Task Force, which makes recommendations for preventive medicine, recommended screening high-risk individuals on a slightly broader scale, which the Lahey and Augusta area screening used. The group recommends screening for those age 55-80 with a 30-pack year or greater history who have stopped smoking for 15 years or less and those age 50 or older with a 20-pack year smoking history and an additional risk factor other than secondhand smoke, such as family history of lung cancer or a personal cancer history. A pack year means smoking one pack a day for 30 years, or a variation like two packs daily for 15 years. After 15 years of not smoking, the lung cancer risk tends to diminish but never vanishes. Schroeder would prefer the screening still not stop there.

A total of 398 individuals signed up for the Augusta area screening, 350 qualified and 264 actually had LDCT. More than 80 patients were not screened in the first year, primarily because of socioeconomic and travel limitations that created a six-week backlog.

Ninety percent of lung cancer is related to cigarette smoking, the leading cause of preventable disease and death in the United States, according to the Centers for Disease Control and Prevention. Symptoms of lung cancer include persistent, intense coughing, shortness of breath, pain in the chest, shoulder or back and changes in the color and/or volume of phlegm or mucus, hoarseness and coughing up blood.

A 2015 survey of smoking by adults by the Centers for Disease Control and Prevention found about 15 percent of adults in the country smoked, rates for Georgia and adjacent South Carolina were between 16-20 percent. Rates in Massachusetts, where the Lahey screening occurred, are 12.8 to 16.4 percent. Rates were highest in certain demographics. As examples, smoking rates were highest among those without a graduate education degree certificate and lowest among those with a graduate degree; higher among those living below the poverty level versus above it; and higher among some minorities such as American Indians and Alaska Natives, multiple- race individuals and blacks.
-end-
For more information about free lung cancer screening at the Georgia Cancer Center and MCG, call 706-721-4726 or email lung@augusta.edu.

Medical College of Georgia at Augusta University

Related Lung Cancer Articles:

AI helps to fight against lung cancer
Lung cancer has been the leading cause of cancer-related deaths in 2015 in United States.
Free lung-cancer screening in the Augusta area finds more than double the cancer rate of previous screenings
The first year of free lung cancer screening in the Augusta, Ga., area found more than double the rate seen in a previous large, national study as well as a Massachusetts-based screening for this No.
Antioxidants and lung cancer risk
An epidemiological study published in Frontiers in Oncology suggests that a diet high in carotenoids and vitamin C may protect against lung cancer.
Lung cancer may go undetected in kidney cancer patients
Could lung cancer be hiding in kidney cancer patients? Researchers with the Harold C.
Hitgen and Cancer Research UK's Manchester Institute enter license agreement in lung cancer
Cancer Research UK, Cancer Research Technology (CRT), the charity's commercial arm, and HitGen Ltd, a privately held biotech company focused on early drug discovery, announced today that they have entered into a licence agreement to develop a novel class of drugs against lung cancer.
Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Huntsman Cancer Institute research holds promise for personalized lung cancer treatments
New research from scientists at Huntsman Cancer Institute (HCI) at the University of Utah uncovered distinct types of tumors within small cell lung cancer that look and act differently from one another.
High levels of estrogen in lung tissue related to lung cancer in postmenopausal women
Researchers from Kumamoto University, Japan have found that postmenopausal women with multicentric adenocarcinoma of the lung have a higher concentration of estrogen in non-cancerous areas of the peripheral lung than similar women diagnosed with single tumor lung cancer.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Pericardial window operation less efficient in cases of lung cancer than any other cancer
Pericardial window operation, a procedure, where abnormal quantity of malignant fluid, surrounding the heart, is drained into the neighbouring chest cavity, is commonly applied to patients diagnosed with cancer.

Related Lung Cancer Reading:

Lung Cancer: From Diagnosis to Treatment
by Walter Scott MD (Author)

According to the American Cancer Society, nearly 220,000 Americans are diagnosed with lung cancer annually. It accounts for nearly 15 percent of all newly diagnosed cancers. If you've been diagnosed, you probably have many questions about the nature of the disease and your treatment options.Walter J. Scott, M.D., has treated thousands of lung cancer patients who have navigated this overwhelming maze of medical tests and procedures. In Lung Cancer: From Diagnosis to Treatment, Dr. Scott helps you understand the process—from getting a diagnosis to going through treatment. He explains... View Details


Lung Cancer: A Practical Approach to Evidence-Based Clinical Evaluation and Management, 1e
by Lynn T. Tanoue MD (Author), Frank C Detterbeck MD FACS FCCP (Author)

Get a quick, expert overview of the many key facets of lung cancer evaluation and management with this concise, practical resource by Drs. Lynn T. Tanoue and Frank Detterbeck. This easy-to-read reference presents a summary of today’s best evidence-based approaches to diagnosis and management in this critical area.

View Details


How to Survive Lung Cancer - A Practical 12-Step Plan
by Michael Lloyd (Author)

Written by a lung cancer survivor who understands what it takes to beat the odds, this book offers unparalleled hope and direction for anyone facing this illness. It is filled with specific exercises and techniques to promote healing and reverse side effects by taking a pro-active approach in helping to restore your mind, body and spirit to an optimum state of health. Endorsed by a Lung Cancer Specialist and Associate Professor at Harvard Medical School, this book combines what the doctors tell you with critical information they don't tell you. Visit www.SurviveLungCancer.com for chapter... View Details


You Can Beat Lung Cancer: Using Alternative/Integrative Interventions
by Carl O. Helvie (Author)

Can you overcome lung cancer without harsh chemicals, surgery and debilitation? Are alternative interventions effective? Why do conventional physicians not use them? Can you prevent cancer recurrences and live into old age without chronic diseases and prescribed medications? This book answers these and other questions.

This is one of the most comprehensive books available on alternative treatments for lung cancer. It explains the treatments used successfully by a health professional/cancer survivor of 36 years and by some of the leading medical and health practitioners currently in the... View Details


Living with Lung Cancer-My Journey
by Thomas E Cappiello (Author)

On October 5 2007, Thomas Cappiello was diagnosed with inoperable Stage IIIA locally-advanced adenocarcinoma (Non-Small Cell Lung Cancer), an incurable disease. This book is the inspirational story of how he beat the odds and survived and thrived in the face of this devastating illness. This book is for patients and caregivers who want to know what life is like after getting a cancer diagnosis.

The story is about overcoming the emotional turmoil and devastation of a cancer diagnosis, dealing with the disease, and making choices. Most of all, it's about living a full life each day.... View Details


100 Questions & Answers About Lung Cancer (100 Questions and Answers)
by Joan H. Schiller (Author), Amy Cipau (Author)

EMPOWER YOURSELF!

No one with lung cancer needs to be alone in their fight against this disease. 100 Questions & Answers About Lung Cancer, Third Edition, guides patients and their families through diagnosis, treatment and survivorship. Providing both the doctor's and patient's point of view, this book is a complete guide to understanding treatment options, post-treatment quality of life, sources of support, and much more. Through 100 Questions & Answers About Lung Cancer, Third Edition, expert authors use their experiences with patients to provide support and hope to the tens of... View Details


Lung Cancer: Treatment and Research
by Karen L. Reckamp (Editor)

This book describes the molecular mechanisms of lung cancer development and progression that determine therapeutic interventions in the era of genomics, when the rapid evolution in lung cancer diagnosis and treatment necessitates critical review of new results to integrate advances into practice.  The text opens with background and emerging information regarding the molecular biology of lung cancer pathogenesis.  Updated results regarding lung cancer prevention and screening are discussed, followed by chapters on diagnostic techniques and pathological evaluation.  This leads on to a... View Details


Anticancer: A New Way of Life
by David Servan-Schreiber MD PhD (Author)

The revolutionary, New York Times bestselling guide to the powerful lifestyle changes that fight and prevent cancer—an integrative approach based on the latest scientific research
 
“A common-sense blueprint for healthy living.” —Chicago Tribune
 
“Resonating with cancer support communities and recommended nationwide.” —Los Angeles Times
 
“Life affirming . . . filled with practical advice.” —The Seattle Times
 
David Servan-Schreiber was a rising... View Details


Lung Cancer: Myths, Facts, Choices--and Hope
by Claudia I. Henschke (Author), Peggy McCarthy (Author), Sarah Wernick (Contributor)

An authoritative book with new lifesaving strategies for those at risk and those already diagnosed.

Lung cancer kills more women than breast cancer, more men than prostate cancer. This authoritative book presents new lifesaving strategies for those already diagnosed and those at risk (including ex-smokers).

Lung cancer is deadly because it's usually found late. Dr. Claudia Henschke's groundbreaking research on early diagnosis, published in Lancet, made headlines worldwide. Now, for the first time, she offers specific recommendations based on her... View Details


Johns Hopkins Patients' Guide to Lung Cancer
by Justin F. Klamerus (Author), Julie R. Brahmer (Author), David S Ettinger (Author)

Johns Hopkins Patients' Guide to Lung Cancer is a concise, easy-to-follow "how to" guide that puts you on the path to wellness by explaining lung cancer treatment from start to finish. It guides you through the overwhelming maze of treatment decisions, simplifies the complicated schedule that lies ahead, and performs the task of putting together your plan of care in layman's terms. Empower yourself with accurate, understandable information that will give you the ability to confidently participate in the decision making about your care and treatment. View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Person You Become
Over the course of our lives, we shed parts of our old selves, embrace new ones, and redefine who we are. This hour, TED speakers explore ideas about the experiences that shape the person we become. Guests include aerobatics pilot and public speaker Janine Shepherd, writers Roxane Gay and Taiye Selasi, activist Jackson Bird, and fashion executive Kaustav Dey.
Now Playing: Science for the People

#478 She Has Her Mother's Laugh
What does heredity really mean? Carl Zimmer would argue it's more than your genes along. In "She Has Her Mother’s Laugh: The Power, Perversions, and Potential of Heredity", Zimmer covers the history of genetics and what kinship and heredity really mean when we're discovering how to alter our own DNA, and, potentially, the DNA of our children.