Prevention, Screening & Health Maintenance
Family Medicine Clerkship
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Lung Cancer
Who are high-risk individuals for developing lung
cancer?
- Smokers over the age of 50
Which imaging procedures are considered in early
detection of lung cancer?
What is the current role of CXR as a screening test for
early detection of cancer lung?
- Studies have proven that CXR as a screening test does
not have any survival advantage and is no longer
recommended.
What is the current role of spiral CT as a screening
test for early detection of cancer lung?
- Sensitivity
- CT is more sensitive than conventional chest
radiography for the detection of lung nodules
- Specificity
- Most of the nodules are benign.
- Some of these nodules prove to be lung cancer.
What factors contribute to the cost for screening
high-risk patients?
- Factors that contribute to the cost of the screening
program include:
- Number of potential candidates for screening
- Cost of spiral CT
- Annual screening
Most of the nodules detected by spiral CT are benign.
What is the morbidity and harm to patients resulting from
investigations of these non specific lesions?
Patients with such nodules need further workup, which can
be costly and nerve racking to prove they are benign.
Possible issues include:
- Unnecessary anxiety
- Expensive follow up evaluations
- Mortality and morbidity from procedures
How is early detection advantageous?
- CT detects more cases of lung cancer.
- More patients screened by CT have resectable
early-stage disease.
What are the limitations of cancer screening?
- Aggressive tumors are not benefited by detection in
the screening procedure.
- There is no proven benefit for early detection of slow
growing tumors.
- There is no proven survival benefit.
What are the current recommendations for lung cancer
screening?
- Several studies are being conducted to identify any
benefit of a screening CT.
- Current recommendations do not call for lung cancer
screening of either the general population or of smokers.
Required Images
- CXR
- Non specific nodule
- Specific nodules
- Spiral CT
- Multiple nodules
- Non specific nodules
- Specific nodules