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U.Va. To Offer Lung Screening Initiative 
July 31, 2000 -- Next month the University of Virginia Health System will kick off a new lung screening initiative to increase early detection of lung disease in smokers and former smokers. A team of physicians from thoracic surgery, radiology, pulmonary medicine and the Cancer Center are working together to offer the U.Va. Healthy Lung Program in hopes of improving survival rates. "The problem is that right now by the time people have symptoms and are diagnosed with lung cancer, about 70 percent are already incurable. The tragic thing is that with all our efforts, with all our improved radiation and chemotherapy and with better surgery, the cure rate has only gone from 13 to 15 percent in the last few years. I've been treating people with lung cancer for 25 years, and I'm tired of fighting those odds," said Dr. Thomas Daniel, professor of surgery at U.Va. and the director for the U.Va. Healthy Lung Program. The program's centerpiece is a 15-minute screening using a low-dose spiral CAT scan that can detect abnormal spots on the lungs. This type of scan is painless, non-invasive and uses about 20 percent of the radiation of a normal CAT scan, Daniel explained. Patients are also tested for emphysema by breathing into an instrument called a spirometer that records the amount of air and the rate of air breathed in over a specified time. Health insurance providers do not currently cover the cost for the screenings, $300. According to Daniel, if abnormalities are found, additional tests and medical care will be covered according to individual health plans. Daniel estimates that the screening program will uncover some type of abnormality in 30 percent of those tested, but that of those, only 10 percent, or 3 in 100, will turn out to be cancerous. Separating the benign findings from the real ones, and determining which require immediate action and which mandate a wait and see approach, is where the real work comes in, he said. Every lesion found more than 7 millimeters in size will be reviewed by U.Va.'s multispecialty, weekly chest conference to reach a consensus on the best course of treatment. "I really think the biggest benefit to this program is the follow-up evaluation we can provide. We have a team of doctors who are willing to put in a lot of time to make this program effective," Daniel said. With the help of an advanced computer system, the program's coordinator, U.Va. nurse Jane Guarini, will track the screening results. Guarini said they hope that in a few years, the data will show the screening program improves lung cancer survival rates, and insurance companies will see it is worth covering. Lung cancer is the most lethal form of cancer among men and women. According to the American Cancer Society, nearly 160,000 people in the U.S. die each year from the disease, more than colon, prostate, breast, ovarian and uterine cancers combined. "Someone who smoked at least 20-pack years, meaning a pack of cigarettes a day for 20 years or two packs a day for ten years, even if they quit years ago, is at risk and should be screened," Daniel said. "Screenings are not a panacea, and this is not a cure, but it's the best chance we have right now to help people survive lung cancer." Daniel said he expects 30 to 40 percent of those tested will also have some early stage of emphysema. Appropriate follow-up care with the Division of Pulmonary Medicine will be recommended for those patients. Information on U.Va.'s smoking cessation program will also be offered to current smokers. Screenings will be available each week on Monday and Wednesday nights from 6 to 9 p.m. at the University Hospital. The program begins Wednesday, September 6. Jane Guarini will also be present at the time of the tests to take information and answer further questions. For more information on this program or to set up an appointment, call (804) 243-6940. Contact: Suzanne Morris |
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