Public health warnings have been effective in getting more Americans to stop smoking cigarettes, but lung cancer still kills more Americans than any other cancer. The percentage of Americans who smoke has decreased by half over about the last 30 years, from 30% in 1980 to 15% in 2012, but there are still over 150,000 deaths a year. Most cancers are still diagnosed at an advanced stage today. In the long run, quitting smoking will reduce lung cancer deaths 20 years from now; however, in the short run, it’s not enough because most lung cancer deaths occur in ex-smokers who remain at risk even after they stop. Smokers need screening for lung cancer annually for 15 years after quitting.
Long-term smokers, especially those over 55, are at increased risk for lung cancer and remain at risk for lung cancer for 15 years after their last cigarette. By 2013, the American Cancer Society, the American Lung Association, the USPTFS and Chest Physicians issued guidelines for annual screening of long term smokers who are over 55 and have at least a 30 pack-year history. There are approximately 9 million smokers and ex-smokers in the United States today who are eligible for low-dose CT lung cancer screening – unfortunately, only about 1 in 4 eligible long-term smokers are getting screened.
Low-dose CT scanning is quick, does not require long breath holding, uses 90% less radiation than a traditional CT scan and is able to detect small early stage cancers when they are easily resectable. Treatment of early lung cancers found on screening CT scans with minimally invasive surgery can result in an 85% survival rate. There are Centers of Excellence for Robotic Invasive Lung Cancer Surgery and also for low-dose CT lung cancer screening. These centers have the appropriate equipment and experienced radiologists who can perform the test. Eligible long-term smokers who are able to receive screening for early lung cancer under Medicare, Medicaid and most insurance plans.
Decreasing lung cancer deaths requires a 2-step approach: smoking cessation and lung cancer screening for eligible long-term smokers. Unfortunately, the medical profession and public awareness campaigns have focused on smoking cessation and have not educated smokers about the need for annual lung cancer screening. Until at-risk smokers get routine annual lung cancer screening, unnecessary deaths from failure to diagnose lung cancer will continue to occur because the delayed diagnosis.