Lung Cancer Screening Program Overview
In 2011, the National Lung Screening Trial results showed a 20 percent reduction in lung cancer mortality with annual Low Dose CT scans for high-risk individuals. Detecting more lung cancers at an earlier stage leads to a better prognosis for patients. The Lung Cancer Screening Program at WVU Cancer Institute Regional Cancer Center strives to diagnose lung cancer at its earliest, most treatable stage.
The Lung Cancer Screening Program features a multidisciplinary team of providers from primary care, radiology, interventional radiology, pumonology, thoracic surgery and medical and radiational oncology. The team uses Lung-RADS, established by ACR, to categorize low dose findings in the event of cancer. Each category is linked with specific recommendations for follow-up. Evaluation of any nodules detected during screenings follows an algorithm developed by the Lung Cancer Screening team. Led by pulmonology, the team reviews cases based on the algorithm and works together to develop a plan of care.
Results are communicated to patients within 72 hours. This includes a phone call, letter and access to the CT scan report on MyChart. The nurse navigator will also be in contact with the PCP regarding results including incidental findings and a plan of care established by the multidisciplinary team. Patients who have been referred to the Lung Cancer Screening Program will have their results entered into our ACR registry. This registry minimizes the number of patients who get lost in the system and do not follow-up with recommendations proposed by the program’s care team.
If you have a patient that is at high risk for developing lung cancer and meets the eligibility requirements described below, you can refer them to our Lung Cancer Screening Program. Private insurance plans and Medicare will cover lung cancer screening with no out-of-pocket expenses if the patient:
- Is between the ages of 55-77
- Is a current smoker or former smoker who quit within the past 15 years
- Has a 30 pack-year smoking history. Click here for pack-years calculator.
- Has no symptoms of lung cancer
- Has not received a chest CT scan in the past 12 months
Cigar smokers and other non-cigarette smokers are not eligible to participate in the Lung Cancer Screening Program at this time.
Shared Decision Making
Education and shared decision making discussions need to be performed and documented by the ordering provider for all baseline lung screening scans per CMS guidelines. This includes:
- Determining patient eligibility to enter the Lung Cancer Screening Program based on the eligibility criteria detailed above
- Explaining the benefits and potential complications of screening including:
- reduced mortality rates from lung cancer
- possibility of false-positive results leading to over-diagnosis
- potential follow-up diagnostic tests as a result of screening
- total radiation exposure
- Discussing the significance of smoking cessation and providing resources and interventions if applicable
- Advising the patient on the importance of adhering to annual lung cancer screenings
A shared decision aid must be utilized during this process. These aids can be provided by the Lung Cancer Screening Program Nurse Navigator. Click here for additional information about shared decision making.
The order for lung cancer screening with low dose CT scan must include ALL of the following information. To view a sample order form click here. (link to be added)
- Date of birth
- Pack-year history of smoking
- Current smoking status
- If a former smoker, the number of years since the patient quit
- Ordering provider’s NPI
- Share decision making documents
- Insurance codes
- Information documenting adherence to program eligibility guidelines including:
- No concerning signs or symptoms of lung cancer
- 12 months since patient’s last chest CT
Link to paper order to be added when available.
Screenshot of Epic order to be added when available.
For more information regarding the Lung Cancer Screening program, please contact Erin Bower, Nurse Navigator, at 304-264-1287 Ext. 31279.