News | September 17, 2013

Key research by physicians and staff contributed to landmark decision

September 17, 2013 – Since 2007, John Muir Health’s Clinical Research Center has been participating in a large-scale research project alongside dozens of other hospitals around the world as part of the International Early Lung Cancer Action Program (I-ELCAP) and has screened 250 patients to date. The study quantifies the benefits of low dose computed tomography (CT) scans for early lung cancer detection in high-risk patients – current and former heavy smokers ages 55 to 80.

The results of this and similar studies indicate that heavy smokers who undergo low dose CT scans compared to being screened with an X-ray have a 20 percent lower risk of dying from lung cancer. Based on these research findings, the U.S. Preventive Services Task Force (USPSTF), an independent panel focused on prevention and evidence-based medicine, is recommending the screening as the new treatment standard for current and former smokers ages 55 to 80 who have smoked a pack a day for 30 years or two packs a day for 15 years, including those who have quit within the past 15 years.

“I believe this new screening standard will bring about a sea change in how lung cancer is detected and treated,” said Michaela Straznicka, co-medical director of John Muir Health’s Thoracic (Lung/Esophageal) Program. 

Today, lung cancer is usually not detected until patients begin to show symptoms and consult a doctor. By then, the cancer has generally reached a later-stage (III or IV) and is extremely difficult to cure – nearly 90 percent of lung cancer patients die from the disease. According to the American Lung Association, lung cancer is the leading cause of cancer death for men and women in the United States. It caused 160,000 deaths in 2012, which is greater than those caused by colorectal, breast, pancreatic and prostate cancers combined. By using low dose CT scans to catch the cancer much earlier, doctors will now be able to offer more treatment options and save more lives. Lung cancers that are identified when they are small, and in the earliest stage, can be treated surgically to achieve cure rates as high as 94 percent.

 “The key is not only identifying these tumors, but then also having the expertise to successfully treat patients using minimally invasive surgical techniques with extremely low complication rates,” said Straznicka.

The final screening recommendation will be issued in three to six months and, under the benefits established by the Affordable Care Act, will be covered at no cost to patients as a preventive service. Currently, patients must pay out-of-pocket for the screening unless they have been part of the clinical trial.

“We applaud the efforts of John Muir Health. They are leaders in the lung cancer screening field and have put the needs of those at risk first and foremost. We commend them,” said Laurie Fenton Ambrose, President and CEO of the Lung Cancer Alliance, a national non-profit that advocates for better lung cancer screening protocols. “Screening those at high risk now will dramatically make a difference and will open the door to much faster advances in research on all stages of lung cancer. It’s a game-changer.”

For people at high-risk for lung cancer, the effects of the new recommendations could be similar to how mammography changed the way women are screened for breast cancer.

“It’s the same process we went through with mammography. It took years and years and now it’s the standard of care for women around the world,” said Dr. Straznicka. “Once insurance companies begin to cover low-dose CT scans for lung cancer screening, high-risk patients can have the security of having this life-saving scan annually.”


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