Dr Hare has a keen interest in screening for early lung cancer. He was involved in interpreting lung cancer screening CT scans as part of the large lung cancer screening trial conducted at The Ottawa Hospital.
Lung cancer screening is not currently available for NHS patients however private lung cancer screening CT scans can be extremely beneficial in asymptomatic patients judged to be at ‘high-risk’.
Screening can detect small lung cancers at a far earlier stage than conventional practice. This potentially allow earlier and more effective treatment. In tandem with Dr Hare's expertise in safe and accurate biopsy of small lung nodules, this approach to 'at-risk' patients can lead to significantly earlier diagnosis.
What is lung cancer screening?
Screening means testing people for early stages of a disease before they have any symptoms. Lung cancer screening uses a test called a low-dose CT scan (LDCT) to detect 'spots' (nodules) in the lungs which could represent early lung cancer.
How is it done?
Screening is performed with a yearly LDCT of the lungs, employing only 10% of the radiation dose of a standard CT chest scan. The scan is painless, non-invasive and takes about 20 seconds once you are on the scanning table. The scan does not need an injection of dye (contrast) as with a standard CT chest.
Why would I want to have lung cancer screening?
Yearly lung cancer screening with LDCT has been shown to save lives by finding 85-90% of lung cancers in their earliest, most curable stage. Early detection makes it much more likely that treatment can be started before the cancer has had a chance to spread, so survival rates are much higher.
Why is lung cancer screening important?
Lung cancer typically has no symptoms in its early stages. Consequently, more than 80 percent of patients with lung cancer are diagnosed in the later stage of the disease, after symptoms occur and when there is less chance of cure.
Who should be screened?
Screening is most useful for people who are at increased risk of developing lung cancer, usually current or prior smokers. It has also been identified as being very important in people who have stopped smoking within the last 15 years. Patients with a family member who has been diagnosed with lung cancer may also benefit from CT screening.
I have never smoked. Should I get screened?
Research shows that in 25% of lung cancer cases there is no direct link to smoking, meaning that some cases are simply "bad luck". Yearly screening however is not currently indicated in never smokers.
I have already had a chest X-ray so why do I need a screening CT scan?
Small lung nodules are usually not visible on a standard chest X-ray and therefore this test should not be used for lung cancer screening. In contrast, a LDCT screening exam can accurately detect tiny spots in your lungs that may potentially represent very early stage lung cancer.
Who interprets the scan?
A chest radiologist, who has had special training and is experienced in interpreting these types of tests, analyses each CT scan.
What does it mean if the screening scan shows a spot in my lung?
Remember: not all abnormal findings are cancer.
Lung nodules are very common but the vast majority of them - more than 97% - are not cancer. However, any nodule has a possibility of representing cancer. The role of LDCT screening is therefore not only to detect nodules, but also to determine the likelihood that any nodule is benign or malignant based upon its features.
Will this screening CT scan also show other lung abnormalities besides cancer?
Yes. Other conditions such as infection, tuberculosis, bronchitis and emphysema may be detected.
My scan showed a lung nodule. What happens next?
The chest radiologist will review the scan results with your respiratory doctor to determine the next steps. These steps may involve: (i) closely following the nodule over time with additional annual LDCT scans; (ii) performing other imaging tests (eg PET scan); (iii) sampling the nodule with a CT-guided lung biopsy; or (iv) even removing the nodule with surgery.
The goal is to offer the least invasive test or treatment that provides the most benefit for you.
How do I get screened?
Lung cancer screening is not currently available through the NHS. As a general rule most insurance plans do not cover screening. Therefore, most patients opt to have lung cancer screening performed privately and choose to pay for the test themselves. If a small lung cancer is discovered during screening then subsequent follow-up tests and treatments are generally available through your insurer.
Do I still need to have an LDCT lung screening scan every year if they don't find a nodule the first time?
Yes. If you are in one of the high-risk groups, guidelines recommend an LDCT lung screening exam every year until you are 75 years old.