Low dose ct scanning - 1265534

doubletime
Posts:18

I've read articles on low dose ct screening and still confused if it is an effective method for finding lung cancer early. AAFP,National Cancer Institute ,MEDCAC, USPSTF,

I currently do not fit the criteria age 55-80 with strong history of smoking. I am 32 and smoked marijuana for 10 years. My mom also a smoker and died before age 50 with BAC lung cancer. I hear reports that if you had a parent die of LC before age 50, it's best to test 10 years before their diagnosis, which was when she was 49 so Im thinking of trying to pay out of pocket for screening when I hit 38. Horrible idea?

What age do you think someone like myself or anyone else who had relative who died young of LC and child is also former smoker?

Thanks

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Reply # - August 22, 2014, 04:03 AM

JimC
Posts: 2753

Hi doubletime,

Low dose CT screening certainly can find lung cancer at an early stage. Here is a video by Dr. West on the subject: http://cancergrace.org/lung/tag/low-dose-ct/ Dr. Hensing discusses the results of the National Lung Screening Trial here: http://cancergrace.org/lung/2011/06/29/the-national-lung-screening-tria… And Dr. West discusses the issue of who should be screened here: http://cancergrace.org/lung/2013/07/22/who-should-have-lung-cancer-scre…

Depending on exactly how often you smoked marijuana (for most pot smokers, their smoking history is much less than heavy cigarette smokers, who often smoke a pack or two a day), your risk is probably not as high as those in the group targeted for screening. As Dr. West wrote:

"there is a real danger that if screening is applied to people at low risk of actually having lung cancer, it’s far more likely that any nodules detected will be benign but will still lead to all of the anxiety, extra scans, and sometimes invasive procedures… just not to lives saved from lung cancer."

The less you smoked and the longer it has been since you quit, the lower your risk of lung cancer. Also, having a family history of lung cancer is somewhat less significant if it is suspected that the cancer was caused by smoking. (You can read about genetics and lung cancer here: http://cancergrace.org/lung/2007/06/17/family-hx-and-lc/ ) So although it is possible that CT screening may help you, it is more likely to find the type of benign nodule that many people have.

JimC
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Reply # - August 22, 2014, 06:17 AM

Dr West
Posts: 4735

Jim clarified the concern: applying screening to pateints who don't meet the screening criteria makes it far, far more likely that any nodules found will actually turn out to be benign, not malignant, so you're likely to have the "positive" results be "false positives".

There are no guidelines or remote consensus favoring lung cancer screening starting 10 years before a parent was diagnosed. Anywhere you were told or read that just made it up (which isn't necessarily a terrible thing to do, since we often need to rely on our best judgment when there's no evidence available, but don't take it as the gospel). That approach of "start screening 10 years before parent diagnosed" is applied for colon cancer screening, which is a very well established, beneficial intervention that has a precursor lesion years before it becomes cancer.

This isn't to say that it's outlandish to do lung cancer screening in your situation, but it falls entirely in the realm of judgment, and I agree with Jim that there's a significant probability that whatever is detected would have a higher probability of being benign but anxiety-causing and "work-up inducing" than the higher yield screening in the better studied population that is outlined in the current guidelines for lung cancer screening.

Good luck.

-Dr. West

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