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Lung Screening Program Opens at Washington Health System
By Kevin Brown

Smoking accounts for 80 percent of all lung cancer deaths, according to the American Cancer Society. On the bright side, the number of deaths from lung cancer is dropping because more people are quitting smoking along with an increase in earlier detection and treatment of lung cancer. However, people who quit smoking still have a risk of developing lung cancer many years after quitting.

The Washington Health System (WHS) is hoping to improve the survival rate of those with lung cancer through its new Lung Screening Program. Just launched, the program offers detection of lung cancer through low-dose computerized tomography (CT) scans of the chest.

Mathew A. Van Deusen, M.D., a pulmonary and thoracic surgeon at WHS, says that, “The goal of the new Lung Screening Program is to identify patients who are at high risk for lung nodules at an earlier stage and avoiding diagnosis at a later stage when treatment is much more challenging and less successful.”

Low-dose CT scans of the chest have been offered for some years, usually for an out-of-pocket fee paid by the patient. What’s different now is that, because of the benefits of the scans demonstrated through the National Lung Screening Trial and, with approval from the U.S. Preventive Services Task Force, health insurance companies are covering the cost of the scans for patients who meet the established criteria.

“From the NLST, this was men and women from 55 to 74 years of age with a history of 30 pack-years of smoking or more and including current smokers and patients who have stopped smoking within 15 years of enrollment,” Dr. Van Deusen says. A pack-year is equivalent to smoking one pack a day for 30 years or two packs a day for 15 years.

Patients who believe they meet the criteria are encouraged to see their primary care physician who will verify that the patient meets the criteria, submit an order to WHS, and schedule the CT scan. The lung screening navigator will contact the patient to review his or her risk factors, enroll the patient in the protocol and confirm that the exam is scheduled.

“Once the scan is obtained, the findings will be reviewed by the radiologist and the higher risk, more suspicious patients are presented to the multidisciplinary physician group for review and decision-making regarding the next step,” Dr. Van Deusen says.

“A decision can be made on the best course of action at that time whether it’s more dedicated imaging such as a CT scan with contrast or a higher quality, diagnostic CT scan or potentially, a PET scan for further information,” explains Dr. Van Deusen. “Beyond that, the patient could be referred to a pulmonary doctor for a bronchoscopy or an interventional radiologist for a CT-guided biopsy or perhaps a thoracic surgeon offering a surgical approach to that disease process,” he says.

“It really depends on what the finding is, what the level of concern about the finding is, and then making a group multidisciplinary decision and that would include the lung doctors, the lung surgeons, the lung cancer doctors, the radiation cancer doctors, pathologists and the radiologists,” Dr. Van Deusen says.

Once patients are enrolled in the Lung Screening Program, they will be qualified to receive a low-dose CT scan every year.

“For that patient who is high-risk, it’s not a “one and done” type of scan,” says Dr. Van Deusen. “Even in patients with low-risk findings, they are qualified for yearly, low-dose CT scans based on their risk. In patients with normal findings, this is more of a longitudinal follow-up making sure that things don’t change over time while they are continuing to meet those high-risk criteria.”

Melissa Zucchero, BS, CNMT, explains her role as lung screening navigator in guiding patients through the Lung Screening Program. “I coordinate the care of the patients who are enrolled in the program by communicating with the patients, the ordering providers and the multidisciplinary team reviewing patients’ exams.”

Melissa says that being a resource for the patient is important to the program. “To be able to pick up the phone and give me a call or to be available when they come in for their CTs - it’s just an extra face, an extra person who is there to make sure they get the care they need. When they have concerns, they can call me directly and we can get to the bottom of it. If it’s not something that I can discuss, I can get them to the person who will,” she says.

Smoking cessation is an important factor in risk-reduction for patients who continue to smoke and that’s a part of the navigator’s discussion with patients. WHS offers a smoking cessation program called “Smoke-Free for Life” at its Wilfred R. Cameron Wellness Center.

According to Melissa, CT scans for patients in the new Lung Screening Program are being offered at WHS Washington Hospital and the WHS Diagnostic Center in Peters Township. Future plans include offering the service at WHS Greene in Waynesburg.

If you believe you meet the criteria for the Lung Screening Program or would like more information, contact your primary care physician or call Lung Screening Navigator Melissa Zucchero at (724) 250-4594.



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