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Expanded Eligibility for Lung Cancer Screening Announced

New Guidelines Designed to Catch More Cases Early

The new guidelines for lung cancer screening with lowdose computed tomography (LDCT) expand eligibility for hundreds more Southern Maryland residents – by lowering the starting age for screening from 55 to 50 years and reducing the tobacco history from 30 to 20 pack-years.

“The ultimate goal is to detect more lung cancers in earlier stages when treatment options have a better chance to produce positive outcomes,” said board-certified medical oncologist Dr. Arati Patel, who is the medical director for the lung health program at CalvertHealth.

St. Leonard resident James Reppenhagen said he’s glad he decided to have it done. “It put my wife’s mind at ease,” said the 57-year-old longtime smoker. (See his story at right.)

The lung cancer screening, which is covered by insurance (including Medicare), is part of a multifaceted effort by CalvertHealth Medical Center (CHMC) in collaboration with American Radiology Services|Calvert Medical Imaging Center and Chesapeake Potomac Regional Cancer Center.

The joint program also includes a nurse navigator to help guide patients through the process, a high-risk clinic to provide patient education and counseling and a multidisciplinary thoracic team to develop individualized care plans for patients.

Early Diagnosis Increases Survivability

According to the Centers for Disease Control and Prevention (CDC), lung cancer is the leading cause of cancer-related deaths in men and women in the United States, with smoking accounting for 90 percent of the cases.

This is of particular concern in Calvert, with its high rate of smoking. Although, the incidence has dipped slightly in recent years, the rate of smoking locally is still higher than the statewide average – with one in seven adults in Calvert reporting smoking in 2018.

Prior to the introduction of low-dose CT, the vast majority of lung cancer cases have historically been found at later stages. Statistics show that of the 22 people diagnosed with lung cancer in Calvert County in 2020, 17 or 77 percent of them were at the more extensive stages of cancer at Stage III or Stage IV lung cancer.

“If someone is detected with lung cancer at an advanced stage, their likelihood of surviving five years is very low, roughly 20 percent,” said Dr. Patel.

“On the other hand, if it is detected at an early stage, their likelihood of surviving five years goes up dramatically to 60-90 percent. This is why screening high-risk patients early on with low-dose scans can make such a difference.”

She went on to add, “The key is to undergo annual scans since lung cancer may develop anytime during smoking or even years after a person has stopped.” Some patients may be screened more often if there are areas the radiologists think need to be watched more carefully.

At present, there are 486 persons actively participating in various stages of the local lung cancer screening program, according to figures provided by American Radiology Services. Patients receive letters reminding them it is time to follow up and the importance of this lifesaving exam. Afterward, their physician receives a report indicating the Lung-RADS® category the result falls into, which can range from benign to clinically significant.

Multidisciplinary Expertise Enhances Care

“The importance of having a multidisciplinary team cannot be emphasized enough,” said Dr. Patel. “Because the treatment of lung cancer involves so many specialties, it’s essential to bring together expertise from multiple fields to provide the best possible treatment plan.”

CalvertHealth’s multidisciplinary thoracic team meets twice a month and includes medical oncology, radiation oncology, radiology and pathology as well as pulmonology and cardiothoracic surgery and the nurse navigator.

The high-risk thoracic clinic at CalvertHealth is designed as an additional resource for those who are at increased risk of lung cancer to provide them with the added surveillance, management and education needed to implement risk-reducing strategies to increase their overall survival.

Thoracic Oncology Nurse Navigator Melissa Bowen, RN, who oversees the high-risk thoracic clinic with Dr. Patel, is readily available to answer questions and assist with any referrals needed depending on what the scan reveals.

“The clinic is the conduit to everything we offer,” said Dr. Patel, “from smoking cessation resources and financial services to nutrition counseling and behavioral health.” For more information, call 410.414.4575.
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