Finding Lung Cancer Early

It might surprise you to learn that your Tri-Cities Cancer Center has the largest community lung cancer screening program in the entire country. How is this possible?

First, a little history: In 2011, the results of the national lung screening trial (NLST) were published in the New England Journal of Medicine. This trial was remarkable in that it showed, for the first time ever, the ability to detect lung cancers in earlier stages with low dose CT (LDCT) based screening. The NLST accrued patients who were deemed to be at high risk for lung cancer, namely those ages 55-80 with a 30 pack-year smoking history (average # of packs per day multiplied by # of years smoked), and either a current smoker or having quit within 15 years. These patients were randomly assigned to have a screening with either a plain chest x-ray or a LDCT.

Amazingly, patients who underwent screening with a LDCT had a 20% reduction in mortality from lung cancer. This may not sound like a lot, but remember that lung cancer is the most common cause of cancer-related death in the entire world. Reducing lung cancer deaths by 20% has as much impact as eliminating every death from prostate cancer.

The trial stirred up an intense debate given the cost to the medical system. The NLST trial was the most expensive clinical trial ever run in the history of man, but it showed that LDCT screening saved lives. For years following the publication of the trial, various factions argued over who was going to pay for it.

The Tri-Cities Cancer Center didn’t wait. While insurers and congressional meetings took place, TCCC took action. In May 2013, the TCCC became the first clinic in Southeastern WA to offer LDCT screening. Since then, TCCC has screened over 600 patients, making our program the largest published community-based screening program in the United States. Since its inception, 10 cancers have been found, most of which were caught in an early stage and treated with curative intent. All active smokers who presented for screening were encouraged to attend our free smoking cessation program.

TCCC has never collected any money for their lung cancer screening program. Each patient has been asked to pay $50 to have their LDCT read by a trained radiologist. All positive findings were reviewed by a multidisciplinary team at our Thoracic Center
of Excellence.

To this day, a number of national organizations have still not endorsed lung cancer screening, citing that community centers are unable to duplicate the NLST results. However, our community-based program has proven to be almost twice as efficient at finding cancers as the results from the landmark national randomized trial. Our screening program has gained national recognition and we have been selected to present our results at the American Medical Association (AMA)’s 2016 national meeting in Orlando. The presentation will be given by Harshil Matta, a 2nd year medical student who interned at our Cancer Center this summer.

We’re not stopping there. Our 2017 goal is to increase understanding, awareness and utilization of LDCT screening by our local primary care providers thereby increasing the number of lives saved by screening in our region. We will continue to do this through our collaborations and strong partnerships with community health networks including Kadlec, Trios Health, and Lourdes Health.

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