Lung cancer is the leading cause of cancer-related death worldwide.
Each year, more than 1.200.000 people are diagnosed with lung cancer worldwide (30.000 in Spain) and 70% of these cases are diagnosed at advanced stages, when the cancer is unlikely to be cured.
Cigarette smoking is the number one risk factor for lung cancer as 80% of the cases are linked to smoking.
The risk of lung cancer increases according to the number of packs of cigarettes smoked per year as well as the duration of exposure to tobacco smoke.
To this date, quitting smoking is the best way to reduce mortality, which is why medical advice, nicotine replacement therapy and anti-smoking advertising campaigns are so important.
Late diagnosis of cancer is caused by a lack of symptoms in earlier stages. For this reason, developing population-screening tools can help diagnose the disease in its early stages in people at risk of lung cancer.
Prospective trials of lung cancer screening using chest radiography or sputum cytology have yielded negative results and are therefore not recommended methods at this time.
The National Lung Screening Trial (NLST) was conducted on 53.454 patients aged 55-74, who smoked 30 packs/year or had quit smoking less than 15 years prior. The results were published in 2011.
Participants who underwent low-dose computed tomographic screening had 20% lower risk of death than those who only underwent chest radiography.
Therefore, lung cancer screening can reduce mortality in high-risk patients.
The greatest risk is obtaining false-positive results, which could lead to unnecessary biopsies, but a PET scan could confirm the results without having to resort to the biopsy.
At HC Marbella we use automatic exposure control systems for dose reduction in chest computed tomography (Siemens CARE Dose4D™), which reduce the side effects of radiation. Not all patients need the same dosage to obtain optimal images for analysis. Therefore, we make sure that no patient receives a higher radiation dose than is strictly necessary.
In the guidelines from the main health organisations such as the American Cancer Society (ACS), the American College of Chest Physicians (ACCP) and the National Comprehensive Cancer Network (NCCN), there is some discrepancy about who would most benefit from low-dose CT scans.
In summary, the ideal candidates are:
Patients at high risk for cancer must discuss the pros and cons of the screening with their doctor, who will ultimately be the one to prescribe the test.
CT scans must be performed annually until the patient reaches the age limit or a comorbidity emerges that would impede curative surgical treatment.
In addition to screening, we offer quit smoking medication to all active smokers, in order to eliminate the main risk factor.
Here at the Pneumology Department of HC Marbella, we recommend you consult your doctor if you have any current lifestyle risk factors.
January 20, 2017
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