Lung-cancer screening: A long time coming

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 - No Magic Bullet

A recent study published in the journal Cancer concluded that patient anxiety associated with a false positive lung-cancer screening was no greater at one and six months post-screening than that of patients who received a negative result.

I could have told you that, and this is why: Former smokers—and presumably current smokers— live in a constant state of anxiety, worried that their venal nicotine habit will result in the discovery, too late, that they have an advanced case of lung cancer. I know because I’m a former smoker.

Ever since the results of NLST were published, I’ve been thinking I ought to have another scan, but my experience to date has been less than encouraging. I did this once before, ten years ago, at my own expense, having chosen a facility that had a 16-slice CT scanner. When I ended up in a well-used EBCT scanner, talking with a cardiologist after the exam about the calcium in my arteries, I was, to say the least, somewhat dissatisfied with the experience.

After the United States Preventive Services Task Force gave low-dose CT lung-cancer screening a B grade, I began to shop around for my next lung-cancer screening exam.  I called three prominent institutions and no one who answered the phone could tell me anything other than how much the out-of-pocket was and whether or not I needed a referral. Upon first request, no one could provide specifications about the scanner on which I would be scanned.

When I walked out of my primary care physician’s office with a referral for a chest CT at a nearby imaging center, I called the center and asked for the technical specifications of the technology. I canceled the appointment after discovering I would have been scanned on a four-slice CT scanner.

I share this with you so that you will know that primary-care physicians have a lot on their minds.  They are the frontline for everything from the common cold to the Ebola virus.  They need to be educated about who should be screened for lung cancer, the optimal technology on which to conduct a lung-cancer screening examination and where to send their patients. You have your work cut out for you.

As I travel down this path, I will pass along anything else I think you should know. Wish me luck!