Monday Medical: Early detection of lung cancer |

Monday Medical: Early detection of lung cancer

Lindsey Reznicek
For Steamboat Pilot & Today

Earlier this year, the U.S. Preventive Services Task Force updated its recommendations for who should receive an annual screening for lung cancer, the leading cause of cancer-related deaths in adults in the United States.

“All cancer screenings are meant to detect cancer early so you have a better chance of survival,” said Dr. Jennifer Kempers, an internal medicine physician in Steamboat Springs and member of the medical staff at UCHealth Yampa Valley Medical Center. “With lung cancer, 75% of those diagnosed present with advanced disease. With proper screenings, our goal is to diagnose the cancer earlier and, therefore, increase the chance of survival.”

Screening considerations and lung cancer risk factors

People ages 50 to 80 who have at least a 20 pack-year smoking history and currently smoke or have quit within the past 15 years are encouraged to have an annual lung cancer screening. Pack history can be calculated by multiplying the number of cigarette packs smoked per day by the number of years smoked.

The screening is done via low-dose computed tomography, known more commonly as low-dose CT.

“Smoking is by far the biggest risk factor in developing lung cancer,” Kempers said.

Kempers said the quantity and duration of a person’s smoking history impacts the risk, and that secondhand smoke exposure can factor into the equation. Environmental exposures, such as asbestos and radon, as well as smoke from coal and pollution, can contribute to one’s risk, too.

Additionally, there is some genetic link for lung cancer. Pre-existing lung diseases like chronic obstructive pulmonary disease caused by smoking and other inflammatory lung diseases can also increase the risk of developing lung cancer.

What does the screening identify?

Once the low-dose CT is completed, a radiologist reads the scan to look for nodules on the lungs. Lung nodules can be from a scar from pneumonia or a prior infection, so the radiologist follows specific guidelines on the size of the nodules and takes into account the patient’s risk factors, which determine whether a nodule needs to be biopsied or monitored over time for change.

Patients with larger nodules or at higher risk of lung cancer may have serial, or more frequent, low-dose CT scans, instead of annual scans to monitor suspicious nodules.

What if nodules are identified?

If a suspicious nodule is found during screening, a biopsy is the next step.

“There are three options to obtain a sample of the lung nodule,” Kempers said. “A CT needle-guided biopsy can be performed, as can a bronchoscopy if the nodule is near the main airway. These can usually be done in Steamboat by either a radiologist or general surgeon. A third option is an open thoracic procedure to collect a specimen, which would take place at a hospital with a cardiothoracic surgeon.”

If the specimen is negative, the patient is encouraged to continue with screening. If the specimen is positive for lung cancer, the patient is referred to an oncology provider for treatment.

Why is lung cancer screening important to discuss with your doctor?

“Your primary care provider knows you, your health and your family history, as well as the various screenings each patient should consider,” Kempers said. “We encourage all our patients to make healthy decisions, including not smoking. We can’t change our genetics, we can’t change a chronic lung disease, but we can remove the biggest risk factor of developing lung cancer.”

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