• By Dennis Douda

CT Lung Scans Recommended for High Risk Patients

July 29, 2013

The U.S. Preventive Services Task Force, of which Mayo Clinic is a partner, is announcing a preliminary recommendation that people at high risk for lung cancer consider having annual low-dose CT scans. Smoking is the biggest risk factor for developing lung cancer, resulting in 85 percent of the lung cancers in the United States, and high-risk individuals are those 55 to 80 years old with a "30 pack year or greater smoking history."  That can translate as someone who has smoked a pack a day for 30 years or someone who smoked two packs a day for 15 years.

Results of the National Lung Screening Trial, published in the fall of 2011, suggested that smokers and former smokers might benefit from lung CT scan screening. It found a 20 percent reduction in lung cancer deaths with CT scan screening. Federal agencies and medical professionals have been discussing the findings ever since. Mayo Clinic took part in that trial, and thoracic surgeon Stephen Cassivi, M.D., calls today's announcement a mandate that will certainly save lives.

Journalists: B-roll of a patient having a lung CT scan and sound bites with Drs. Cassivi and Midthun are available in the downloads. 

/// SOUND BITE   Stephen Cassivi, M.D. / Mayo Clinic Thoracic Surgeon  -  (Cassivi pronounced KASS-uh-vee) CASSIVI SOT #2 - A MANDATE TO SAVE LIVES:  /// SOT  "This is the first major federal body to recognize the benefit for patients and for people in terms of saving lives of people with lung cancer."  TRT :12

Mayo Clinic pulmonologist David Midthun, M.D., says a big reason survival rates for lung cancer are so poor is that there are few clues a person has it until it's too advanced.

/// SOUND BITE  David Midthun, M.D. / Mayo Clinic Pulmonologist  - (Midthun pronounced Mih-TOON) 
MIDTHUN #1 - TOO OFTEN TOO LATE /// SOT  “We’re finding it with symptoms at a point where it’s no longer curable and the hope with CT screening is that we’ll find many more early stage cancers at a time when we can intervene.”  TRT :15

Dr. Midthun says he is hopeful medical insurance providers will see the value of the task force recommendation and decide to pay for CT scans for high-risk patients because, as of today, very few companies will cover it.

/// SOUND BITE  David Midthun, M.D. / Mayo Clinic Pulmonologist  - (Midthun pronounced Mih-TOON) 
MIDTHUN #2 - INSURANCE PROVIDER CONCERN  /// SOT   “A large number of people who fall into this high-risk category who are going to be recommended to have screening are not going to have the financial means to pursue it.”  TRT :13 
Dr. Cassivi says results of the National Lung Screening Trial indicate one life will be saved for every 300 high-risk patients who are screened. So why has the task force waited nearly two years to take this action? Cassivi says it's because an entire, well-conceived program needed to be in place to address many factors from patient counseling to follow-up care.
/// SOUND BITE   Stephen Cassivi, M.D. / Mayo Clinic Thoracic Surgeon  -  (Cassivi pronounced KASS-uh-vee) CASSIVI #1 -  MORE THAN JUST A TEST /// SOT  "It involves more than just a CT scan.  It involves choosing the right patients to include in the screening program, so those most at risk.  As well as having a structured plan when you find something.” TRT :17
Background on the National Lung Screening Trial (NLST):  The NLST was the first indication that any test can reduce deaths from lung cancer. The study involved more than 50,000 current and former heavy smokers — people who smoked the equivalent of a pack of cigarettes a day for 30 years — ages 55 to 74. Participants were randomized between low-dose spiral CT scan and chest X-ray at the start of the trial. They received annual screening tests for three years and then were followed for five years. The initial results of this trial revealed a 20.3 percent reduction in lung cancer deaths with CT scan screening.

Please login or become a member to post a comment.