SDM – Radiation Exposure - PowerPoint Presentation

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SDM – Radiation Exposure

G0296 - SDM Aides

Ky Cancer Program (KCP)

Ky LEADS Collaborative

Flyer/Poster for Exam Rooms

LUNG CANCER SCREENING – Low-Dose CAT Scan

Low-dose Chest CT Lung Cancer Screening (LDCT ) is a noninvasive screening test that uses a simple CT scan to detect nodules, or findings suspicious for lung cancer. No IV or dye is required, and the test takes less than 3 minutes. Most often, your typical clothing is permissible for the scan. This test is indicated to screen adults in the age range of 55 – 77 years old, that have smoked 30 pack years, and have not quit more than 15 years ago. Pack-years of smoking is calculated by multiplying how many packs per day an individual smoked by the years of smoking history.

The greatest benefit of this test is detecting possible lung cancer in the earliest stages, when the chance of cure is far greater than if detected in later stages III or IV, which unfortunately is when most lung cancers are detected. Lung cancer detected in the later stage continues to have relatively poor cure rates and outcomes. Mammograms and Colonoscopies, and other screening tests have led to dramatic increase in the survival rates for patients with these respective cancers, due to early detection.

The objective is to address lung cancer in a similar fashion

. Risks of LDCT Screening include a low radiation exposure, a false positive test, potential over diagnosis, or the need for further testing which usually simply involves follow up scanning. The radiation exposure form natural background sources is 3 millisievert

(mSv)

per year. LDCTs have a radiation dose of 1.5 mSv, compared to 7 mSv for routine CT of Chest, and 0.4 mSv for a mammogram.

AVS Smartphrase

: MGLDCT

Lung cancer is the leading cause of cancer related death

in Kentucky, the United States, and the World.

Nationally there are more lung cancer deaths than the other leading 3 causes of cancer death combined, including breast and colon cancer. Kentucky is at the epicenter of the fight against lung cancer in the USA. In

Kentucky, there are more lung cancer deaths than the next 5 causes of cancer deaths combined. Ky. is the #1 state for lung cancer prevalence in women. The overall lung cancer 5-year survival rate is 21.7%; if found in Stage 1 this survival rate improves dramatically to 90% or more. Unfortunately, most lung cancer is diagnosed in the late stages, when survival rates can be as low as 1%; early lung cancers are traditionally most often found by chance. Low-dose CT of the Chest Lung Cancer Screening can reduce deaths from lung cancer by 20%.

This screening test has a 94% sensitivity in detecting lung cancer in the earliest stages but cannot find all lung cancers. A positive test

may indicate the presence of lung cancer. However, lung nodules are very common, especially in the Ohio River Valley, and many people without cancer have these nodules.

90% of lung nodules are benign

. Certain nodule criteria and results will direct a well-coordinated healthcare team to recommend additional evaluation and testing, working in close cooperation with your primary care provider. Nodules that are 8 mm or larger will require further testing.

About 6 - 11% of screening tests require a subsequent procedure.

A

negative test

indicates a very low likelihood that a significant or advanced lung cancer is present. Annual LDCT scanning will continue to be recommended until outside of the screening age group or > 15 years since smoked.

If you have any questions, do not hesitate to contact our patient navigators at 858-301-WELL (9355).Traditional Medicare and Medicare Advantage plans cover the test, without any co-pays or deductibles. Other Commercial or Private Insurers usually cover part or all of the test. Contact your insurance carrier or make certain the test is preauthorized prior to proceeding with the study.

If presently smoking, it is certainly recommended that you consider smoking cessation. Consider contacting FRESHSTART at (859) 301-5570,

www.stelizabeth.com/freshstart

, or QUIT NOW KENTUCKY at 1-800-784-8669, www.quitnowkentucky.org.

Emphasizing Accuracy of Smoking History

Registry Summary

*

NLST

- 24.2% Positive Findings - >4mm (18,146 positive scan/75,126 Total LDCTs done)

Also positive if effusion, adenopathy, or other abnormalities suspicious for Lung Cancer

***Positive LDCT determined

negative for LC

/Total Positive LDCT Scans =

FALSE DISCOVERY RATE

NLST

- 96.4% False Positive (17,497/18,146), really the false discovery Rate

- the

actual FALSE POSITIVE RATE

is 23.3% (18,146 - 649/75,126)

** -

FALSE POSITIVE RATE

is false positive scans (positive LDCT scan determined to be negative for LC)/ Total all LDCT scans

Analysis of Positive Scans - St. Elizabeth Healthcare --- 1/1/2015 - 8/31/2020

Year

2015

2016

2017

201820192020TOTAL% ScansFalse PositiveFalse Discovery# Scans to Total LDCT LC Scr. SCANS252753196535854082218112818******find 1 LC Annual    181513563171     Baseline    22678253092    Cat 1 1274571164219423121309756359.00%   Cat 2 762015068871250627354727.67%   Cat 3 (Indeterminate)22471432402501448466.60%   Cat 4 (Suspicious) - Total27481522642701018626.72%4.93%73.32%  Cat 4A1633108186188706014.69%    Cat 4B1115447882282582.01%       Cat 4X      330.02%   Cat 3 + Cat 4 - Combined4995295504520245170813.33%11.53%86.53% Lung Cancer516378273172301.79% #LC/per Tot LDCT =55.7

Lung-RADS v1.1

Lung-RADS =

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