Smokers beware! The importance and methods of lung cancer screening

Lung cancer is the second most common type of cancer worldwide and is also noted as the deadliest. Tobacco use is accepted as one of the primary risk factors for the disease. Assoc. Prof. Dr. Tayfun Çalışkan, a Chest Diseases Specialist at Anadolu Medical Center, stated that smoking an average of one pack of cigarettes a day for a year is defined in medicine as 'one pack-year,' and added, 'It is recommended that individuals between the ages of 50-80 who have smoked 20 pack-years and have quit smoking within the last 15 years undergo screening with a low-dose lung CT scan every year. Screenings can be stopped if the person has not smoked for 15 years, if there are other health problems that limit life expectancy, or if the person has reached the age of 81,' he said.

Stating that the patient's symptoms, physical examination, and subsequent planned imaging methods are utilized in the diagnosis of lung cancer, an expert explained, "Chest X-rays are generally taken for patients in the chest diseases outpatient clinic, but only about 70-75 percent of the lungs can be analyzed with this imaging method. For this reason, a lung computed tomography (CT) scan must be performed for diagnosis in patients suspected of having cancer."

THE STEP AFTER CT IS PET-CT

Sharing that the next stage for patients who have a lesion larger than 1 cm (defined as a nodule between 1-3 cm and a mass if larger than 3 cm) detected on a lung CT scan is a PET-CT, or Positron Emission Tomography and computed tomography (CT) scan, Assoc. Prof. Dr. Çalışkan said, 'PET-CT is an advanced examination where lesions, or abnormal tissues, detected in the lung are examined to comment on the suspicion of cancer. Scoring systems that calculate the risk of cancer are used for millimetric nodules, i.e., those smaller than 1 cm; the radiological characteristics and size of the nodule are evaluated together, and a decision for follow-up or further examination is made accordingly. PET-CT may also be recommended for millimetric nodules of 8 mm and above,' he said.

BENIGN LESIONS CAN BE MISTAKEN FOR CANCER

In patients where findings favoring cancer are detected as a result of a PET-CT, options for biopsy or surgical removal of the lesion are evaluated. 'The decision here is made according to the patient's preferences, accompanying other diseases, lung functions, and the characteristics of the lesion. In this imaging method, some benign lesions formed due to infection can also cause suspicion of cancer. To prevent such misleading situations, the patient may be given antibiotics for a period before the PET-CT, and then a radiological check can be performed with a lung CT scan. These serious choices are evaluated in a multidisciplinary manner in councils that include branches such as chest diseases, radiology, and, when necessary, thoracic surgery, medical oncology, and nuclear medicine,' it was stated.

BLOOD TESTS ARE NOT SUFFICIENT FOR CANCER SCREENING OR DIAGNOSIS

Emphasizing that tumor markers can be utilized through blood tests, but that normal values do not rule out cancer and high values do not prove the presence of cancer, Çalışkan stated, 'For this reason, the routine use of tumor markers in lung cancer screening is generally not recommended. In international guidelines containing current data on lung cancer, a low-dose lung CT scan once a year is recommended instead of this method for lung cancer screening,' he explained.

RAPID DIAGNOSIS MUST BE MADE AGAINST RAPIDLY PROGRESSING LUNG CANCER

The specialist doctor said, 'Choosing a biopsy method that has the lowest risk of complications for the patient, a high diagnostic rate, and is fast, and if possible, provides both diagnosis and staging in a single procedure, is important, especially in this rapidly progressing type of cancer. Which biopsy method to choose is the authority and responsibility of the chest diseases specialty. The decision for a biopsy should be made after the patient has undergone a PET-CT and/or brain MRI. Since lung cancer is fast-moving and generally has a poor prognosis, the goal should be to complete diagnostic procedures without delay.' 

News Source: 12punto