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This year, the U.S. Preventive Services Task Force (USPSTF) released new guidelines for both colorectal and lung cancer screenings. The new guidelines were put in place to catch these cancers at earlier stages and improve patient outcomes and survival rates. Here’s an overview of the new guidelines and how to talk to patients about getting screened.
Lung Cancer Screening Guidelines
Age and pack-year history are two important factors when determining a patient’s risk for lung cancer and eligibility for screening. Your patient’s pack-year is calculated by multiplying the average number of cigarette packs smoked per day by the number of years as a smoker. For instance, someone who smoked two packs per day for five years has a 10 pack-year history.
The new recommendation for lung cancer screening includes people who are 50-80 years old and have a 20 pack-year history or more. Screening is performed by taking a low-dose CT scan of the lungs to look for any lung nodules or abnormalities.
“It’s been proven that this low-dose CT scan can save lives,” said Charles Shieh, M.D., a thoracic surgeon and director of the Lung Cancer program at Inspira Health. “The screening guidelines have been expanded because of the test’s effectiveness. Now, more patients will be eligible, which means we have a better chance of catching and treating lung cancer early and reducing mortality rates.”
While screening may catch lung cancer at an earlier stage, it’s still important to encourage patients who are smokers to quit. Even lifelong smokers will experience health benefits from quitting. Inspira’s Quit Center not only provides lung cancer screenings, but also provider-assisted smoking cessation services including personal and group counseling, a quit plan, nicotine replacement therapy and more.
“It’s never too late to quit—physiologic changes will happen almost immediately after smoking cessation, so it’s important to communicate and share the benefits of quitting with patients, no matter how long they’ve been smoking,” said Dr. Shieh. “If your patients are struggling to quit smoking, the Quit Center is here to help.”
Colorectal Cancer Screening Guidelines
The USPSTF has now recommended screenings start at age 45 instead of age 50 for people with an average risk of colorectal cancer. “There were many factors that went into this change in screening guidelines,” said Peter J. Senatore, Jr., M.D., director of the Rectal Cancer Program at Inspira Health. “There has been a rise in cases of colorectal cancer in younger people in recent decades, especially when it comes to fatal diagnoses. At the same time, over the past few decades, we’ve seen a gradual reduction in colorectal cancer incidence and mortality in people who undergo screening.”
About 10 percent of lives lost because of colorectal cancer occur in people who are diagnosed within ages 45-50. Early screening is now becoming increasingly important to reduce mortality rates from colorectal cancer.
“If we catch colon cancer in its earliest stage, over 90 percent of cases are cured. And stage one rectal cancer has a cure rate percentage in the high 80s,” said Dr. Senatore. “But, it is a silent killer because it can grow without any symptoms whatsoever. So, we don’t want to wait for symptoms to appear.”
For patients who are nervous about getting a colonoscopy, which is performed every 10 years and considered the gold standard of screenings, it’s important to let them know that there are alternative options that are effective, convenient and less invasive. Options for colorectal cancer screening include:
- Guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT)—both using stool samples collected at home and performed once per year
- FIT-DNA test—using an entire bowel movement and performed every three years
- CT colonography—also called a virtual colonoscopy and performed every five years
How to Talk to Your Patients About Cancer Screening
Cancer screening is an important part of preventive health care, whether your patient is eligible for lung cancer screening, colorectal cancer screening or both.
Patients may be nervous about radiation from a lung cancer screening or getting a colonoscopy, but it’s important to communicate the benefits of catching cancer early. “We have tools to treat cancer, but if we catch it early on it can change the course of your treatment and even save your life,” said Dr. Shieh. Dr. Senatore shared a similar sentiment: “Colorectal cancers are not only curable, but preventable with early screening.”
