In the Clinic

On Cancer: New Online Tool Helps People Decide Whether to Be Screened for Lung Cancer

By Jim Stallard, MA, Writer/Editor  |  Tuesday, July 30, 2013
Pictured: Peter Bach Pulmonary specialist Peter Bach

The US Preventive Services Task Force (USPSTF) yesterday posted a draft recommendation statement on screening for lung cancer, advising that people who are at high risk for the disease receive annual low-dose CT scans. When used in the correct setting, these scans can prevent a substantial number of lung cancer–related deaths.

But deciding whether to be screened can be difficult. Even among a high-risk group, the risk of lung cancer varies between individuals. To help people determine whether screening will benefit them, Memorial Sloan Kettering has developed a lung cancer screening decision tool that is now available for use by the public.

The new decision tool is an online questionnaire that asks about lung cancer risk factors and is completely confidential. It can help people understand the likelihood that screening will be beneficial to them by first calculating the chance that a person will develop and die of lung cancer, and then figuring out how likely it is that screening will prevent this from happening. 

The tool is appropriate for people fitting high-risk criteria similar (although not identical) to those described in the USPSTF recommendation. Those using the tool are asked to enter information such as age and smoking history based on pack years. (A pack year is calculated by multiplying the number of years an individual has smoked by the number of packs per day.)

“Our decision tool helps clinicians and patients determine the chance that screening will actually be helpful,” says Memorial Sloan Kettering epidemiologist and pulmonary and critical care physician Peter B. Bach, who helped develop the screening tool. “For those whose risk for developing lung cancer is not sufficiently high, a CT scan — even low dose — might do more harm than good, since it involves radiation exposure. The scans also can pick up abnormalities that wouldn’t cause harm but may lead patients to undergo unnecessary procedures.”

The screening decision tool was developed and tested by researchers at Memorial Sloan Kettering in collaboration with the Fred Hutchinson Cancer Research Center in Seattle. It is based on data from the Carotene and Retinol Efficacy Trial (CARET), a large, randomized trial of lung cancer prevention. CARET has been shown in other studies to be effective in predicting whether a person will develop lung cancer.

“For people who use this prediction tool, we advise them to discuss the results with their doctor,” Dr. Bach adds. “This is not meant to provide a definitive answer on whether to undergo screening but an important piece of information to guide a decision.”

Earlier this summer, Memorial Sloan Kettering launched a new Lung Cancer Screening Program that offers low-dose CT screening to current and former smokers who fit specific criteria in order to detect the disease at its earliest stage.

Read a New York Times story about the new USPSTF recommendations including comments from Dr. Bach and a New York Daily News article featuring Memorial Sloan Kettering thoracic surgeon Nabil P. Rizk.

Comments

I am not a smoker (NEVER). However, my mother and sister died of lung cancer at age 56 and 70 respectively. They were both long time smokers. My question is should I be screened for lung cancer? I am concerned that this could be a genetic female family problem. What screening test / tool would you suggest?

Jane, if you are concerned about a family history of cancer, we recommend you read our information about hereditary cancer and genetics: http://www.mskcc.org/cancer-care/hereditary-genetics. If you would like to speak with someone from our clinical genetics service, you can call 646-888-4050. Thank you for your comment.

i'M SURE THAT I AM NOT ALONE IS STATING THAT FOR THE 50-70 Y/O AGE GROUP THERE ARE NOT MANY PEOPLE THAT CAN TRANSLATE YOUR PROCEDURE FOR PRIVACY INSTRUCTIONS. PLEASE SIMPLIFY THEM.

Thank you for your comment. We have forwarded your concern to our privacy office.

I recently had a CT Scan and no fibrosis. It stated some very small nodules seen. I am a former smoker. I was advised to have another CT Scan in 6 months, again 6 months , then 1 year. Do you agree?

Evelyn, we are not able to answer individual medical questions on our blog. If you'd like to speak to someone about making an appointment with a doctor at Memorial Sloan-Kettering, you can call 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment. Thank you for your comment.

I tried to use "Lung Cancer Screening Decision Tool, " but ended upgetting a error that I could not use the tool remotely when I submitted the responses.

Ted, thank you for your comment. The tool appears to be working now, but if you're still having that problem we suggest you try this:

1. On the menu bar, click on the Firefox menu and select Preferences...
2. Select the Advanced panel.
3. Click on the Network tab.
4. In the Cached Web Content section, click Clear Now.
5. Close the Preferences window

Although I quit smoking cigarettes over 20 years ago, until recently I smoked marijuana on a daily basis. Since numerous Americans find themselves in a similar situation, could the survey be tweaked to include this behavior?

Rob, thank you for your comment. We consulted with Dr. Bach, who responded that he and his colleagues haven’t incorporated marijuana use into the model and are not aware of any models that have. The evidence on how much marijuana smoking would be needed to meaningfully increase lung cancer risk is inconclusive, but it would be a significant amount. You might want to visit the American Cancer Society’s lung cancer risk factors page, which includes a section on marijuana, at this link:

http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-risk-factors

dear sir,
I am from india. one of my cousin diagnosed T-cell Non hodking's lymphoma consistent with T cell, ALK Positive anaplastic large cell lymphoma (immmuna reactive score 4+ for CD45R0 and Alk-1) . please suggest whether is it curable in your hospital or not. and tell us what is the procedure to admit in your hospital and detail of expanse and duration of time and how many peoples will come along with patient.

Thanks with Best regards,
Imran khan
00+918261092191

Hi Imran, to find out about making an appointment at Memorial Sloan-Kettering, you or your cousin can contact our International Center by calling (1-212-639-4900) or go to http://www.mskcc.org/cancer-care/international-patients. Thanks for your comment.

I recently had a ct scan because of stomach issues. I just recently received the results. which stated I had several non specific small nodular densities at the posterolateral right lung base. I am a former smoker, age 47. Should I be concerned and Is this a lung cancer diagnosis.?

Lisa, we are unable to answer specific medical questions on our blog. If you would like to make an appointment with a Memorial Sloan-Kettering physician, please call our Physician Referral Service at 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment. Thanks for your comment.

Dear Sir/Madam,
I would be interested in knowing if you offer second opinions by sending/mailing all reports and films to your facility by a team of doctors?
If so, how would I go about it and what is the cost?

Darlene, if you would like to speak with someone about receiving a second opinion from Memorial Sloan-Kettering, you can call 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment for more information. Thank you for your comment.

Good! Lung cancer is the leading cause death so any thing done to slash this rate is significant.
This new technique will help in finding lung cancer at earlier stages when it is curable otherwise when it is diagnosed it is usually too late.

DbaiG
Bolee.com

i am ashraf mc a chordoma patient since 30 years, it has affected my both pelvis, for last three years it has spread to my lung and liver also,the size of tumor is 7cm, what is the suitable treatment for cure the desease. best regards ashraf mc.

Ashraf, we are not able to answer individual medical questions on our blog. If you'd like to speak with a Memorial Sloan-Kettering doctor about your treatment, you can call 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment for more information. Thank you for your comment.

I am anamika .I am 37 years old. I have CML. my treatment is in SGPGI in lucknow.how we cure these deasea.

Anamika, to learn how Memorial Sloan-Kettering treats CML, you can go to http://www.mskcc.org/cancer-care/adult/chronic-myelogenous-leukemia to learn more. To learn more about making an appointment from outside the United States, you can contact our International Center at http://www.mskcc.org/cancer-care/international-patients. Thank you for your comment.

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