Lung Cancer has been closely associated with smoking and is thought to cause up to 80 to 90 percent of lung cancer cases. However, there are still a percentage of people diagnosed with lung cancer who have never smoked a cigarette in their lives.
Important strides are being made in the way we screen, diagnose and treat lung cancer. New diagnostic and treatment techniques as well as new screening guidelines are helping doctors find lung cancer earlier and treat it more efficiently.
Nebraska Medicine offers low-dose CT scan lung cancer screenings, which can detect lung cancer nodules in Stage IA when the cure rate can be as high as 90 percent or more. With traditional X-rays, approximately 75 percent of lung cancer cases are found in Stage III/IV, when cure rates drop to 5 percent and lower.
How a Lung Cancer Screening Plan Works
Once you have opted into a screening program, we recommend receiving an annual low-dose CT scan of the chest area. Chest X-rays do not qualify as an acceptable screening option. Low-dose CT scans are only recommended for high-risk populations. This includes individuals who meet the following criteria laid out by the National Comprehensive Cancer Network, an organization to which Nebraska Medicine belongs:
- Smokers and former smokers
- You're between the ages of 55 and 74 years old
- You smoked more than a pack and a half each day for 30 or more years and quit smoking fewer than 15 years ago
- Alternatively, you're at least 50 years old, and smoked a pack and half for more than 20 years, and had other lung cancer risk factors in your life
By participating in the lung cancer screening program through Nebraska Medicine, you have access to a team of doctors with specialized training and experience in evaluating, diagnosing and treating abnormal lung lesions, should the need arise.
Current smokers should quit smoking with the help of our smoking cessation program. Continuing to smoke and testing for lung cancer annually does not lower your risk of contracting lung cancer.
Other conditions may be incidentally found on the chest CT scan. If something else is found, we'll alert you and your doctor.
What to Expect After a Low-Dose CT Scan Lung Cancer Screening:
- A growth on your lungs doesn't necessarily mean cancer. If something is found, however, it's important to follow through with all scheduled appointments to determine its cause and origin.
- If the lung cancer screening CT scan results are negative and no abnormalities are found, you should expect to receive a phone call within two business days and a letter in the mail within seven to 10 business days. This letter will also include a recommendation for an annual low-dose CT scan of the chest based on the screening guidelines.
- If the lung cancer screening CT scan shows something abnormal, a nurse will call you to schedule an appointment with a thoracic surgeon.
- If the lung cancer screening CT scan shows an abnormality that is not related to the lungs, a nurse will call you and help you set up an appointment with the appropriate specialist.
If You Want to be Screened on Medicaid and Medicare:
The Centers for Medicare and Medicaid Services (CMS) have specific requirements for documentation of lung cancer screenings. You must be seen by a referring provider prior to any screening. If you do not have a doctor's reference, appointments are available at the Fred & Pamela Buffett Cancer Center. To schedule an appointment, please call 402-559-4389.
All doctors should reference patient discussions and review the following:
- Benefits vs. risks of the screenings (including radiation exposure)
- Follow-up diagnostic testing and annual screenings
- Potential over-diagnosis or false positive rates
- Smoking cessation programs and reasons to abstain from smoking
The doctor must document your age and birth date. CMS requires you to be between 55 to 77 years old and have no current signs or symptoms of lung cancer. The number of years you have smoked and average number of cigarette packs smoked must be recorded by your doctor. In order to meet the requirements for CMS documentation, you must have a 30-pack-a-year history (one pack a day for 30 years or two packs a day for 15 years). You must also be a current smoker or have quit in the last 15 years. If you have quit smoking, your doctor should document the length of time since you've quit.
Prior to ordering a lung cancer screening, the provider must include his or her provider identification (NPI) and a valid signature in the patient’s electronic health record or on the faxed order.
Want to learn about how we can help you quit smoking? Visit our smoking cessation program.
Nebraska Medicine has the Experience and Expertise
Nebraska Medicine's lung cancer team treats some of the sickest and most complicated lung patients in the region. The team’s experience and dedicated expertise enables them to treat the elderly as well as high risk patients who have had other complications like heart disease, lung disease or other medical problems. Their experience also allows them to perform minimally invasive lobectomies and segmentectomies and they are the only team in the area that routinely performs surgery on Stage III lung cancer patients after chemotherapy and radiation.
Technology to Get the Best and Fastest Diagnosis
Our lung cancer team also uses a new minimally invasive biopsy technique called electromagnet navigation bronchoscopy to biopsy nodules found during the screening. This device is a computer-guided system that allows physicians to take multiple biopsies and determine immediately if they are cancerous. The biopsies are large enough to allow for mutation analysis and the development of customized chemotherapy.
This new technique allows doctors to start therapy the very next day as opposed to a week or two later. Other methods require physician to wait for biopsy results, followed by an outpatient surgery procedure to stage the tumor.
At the time of the diagnosis, our surgical team can also perform an endobronchial ultrasound, a procedure that can be performed during the bronchoscopy to figure out what stage of lung cancer we're in. It allows us the surgeon to view regions of the lungs and surrounding chest area that have traditionally required more invasive surgical procedures to evaluate. If the lymph nodes are negative but the tumor is positive for cancer, surgery to remove the cancer can be performed at the same time.