The best hope for curing lung cancer is finding it as early as possible; the I-ELCAP research shows that annual CT screening can find 85% of lung cancers in their earliest, most curable stage. If you are at risk, a CT scan can detect tiny spots on your lungs (called 'nodules') that may indicate lung cancer in this early stage (New England Journal of Medicine 2006; 355; 1763-1771).
Advances in CT scanning now allow individuals to undergo a painless, non-invasive scan that takes about 20 seconds once you have registered, changed clothing and are on the scanning table.
The entire process of registering and filling out our simple questionnaire can be completed in less than half an hour.
A radiologist who has had special training and is experienced in interpreting these types of tests analyzes each CT scan.
The radiologists will discuss any findings and necessary follow-up with the participant's physician.
Lung cancer results in more deaths in the United States than any other cancer; in fact, it accounts for more deaths than breast, cervix, colon, and prostate cancer combined.
Because lung cancer has no symptoms in its early stages, more than 85 percent of the men and women who are diagnosed with lung cancer today are diagnosed in a late stage, after symptoms occur and when there is very little chance of cure. As a result, approximately 95% of the 173,000 people diagnosed each year die from the disease.
With early detection, 85 percent of cancers can be found in the earliest, most curable stage. If treated promptly with surgery, their cure rate is 92% (New England Journal of Medicine 2006: 355: 1763-1771).
The latest research from I-ELCAP shows that patients diagnosed with lung cancer as a result of annual CT screening have an overall cure rate of 80%, regardless of stage and type of treatment. When cancers are found at the earliest stage (85% of the patients) and are immediately removed with surgery, the research shows a cure rate of 92%. The research involves over 31,000 patients who are considered to be at risk for lung cancer due to a combination of their age and histories of cigarette smoking, occupational exposure to carcinogens, or exposure to second-hand smoke (New England Journal of Medicine 2006: 355: 1763-1771).
The initial findings of the ELCAP team, published in The Lancet, a prestigious medical journal, and on July 9, 1999 on the front page of The New York Times, showed that 85% of the cancers that are found with CT screening are small and in the more curable early stage.
Chest x-rays done at the same time failed to reveal 85 percent of the early-stage cancers detected by the CT scans. The ELCAP team also developed procedures and analytic techniques for highly accurate assessment of tumor growth, significantly reducing the chances of unnecessary additional tests and treatments.
It was already well-known that small early stage lung cancers are much more curable than those found in later stages as 10-year survival rates of 90% or more had been reported by others.
Each participating institution has their own eligibility criteria and these can be obtained by calling the institution; contact information is on the I-ELCAP Members page.
Each institution charges for the screening CT scan, with most United States facilities charging between $200 and $400; some locations, however, provide free CT scans to study participants if the facility is engaged in a funded research program. If a positive or questionable finding is seen and follow-up procedures are required (such as a diagnostic CT scans or biopsy) the participant is responsible for the costs either through insurance or self-payment.
CT screening uses a lower dose compared to standard CT scans. We strive to keep the dose between 1-2 mSv (millisieverts) or lower, although for individual patients it may be slightly higher than this value. As a comparison, average background radiation in the US is approximately 3 mSv/ year and in Denver, Colorado, due to the higher altitude it is 11.8 mSv/year.
Each participant, with guidance from the Coordinator, will be asked to fill out a confidential questionnaire on smoking habits and other relevant risk factors for lung cancer. Participants also must sign a standard CT scan consent form, which also requires them to have a follow-up screening, one year after the initial screening.
In communities of color--which traditionally have limited access to health care information, diagnostic procedures, and medical treatment--lung cancer kills at disproportionate rates. The disease accounts for 25 percent of all cancers diagnosed in African American men; this is almost double the rate of lung cancer deaths for the overall US population. The lung cancer mortality rate for African American men in the 1990s was over 46 percent higher than that of white men. Cancer death rates among African American women are 20 percent higher than among white women.
Unfortunately, less data are available on Hispanic men and women. The American Lung Association recently reported that "smoking behaviors and lung cancer rates differ among different segments of the Hispanic population, and closer examination is needed to get a more accurate picture of each group."
A chest x-ray shows only two views of your chest (front and side), while a CT scan shows cross-sectional images all through your chest-from the very top of your lungs through the lung bases. Thus, tiny abnormalities (that could be early stage lung cancer) can be found which would never have been seen on a chest x-ray.
Yes. Old or new pneumonia, tuberculosis, or emphysema may be detected.
A limited evaluation will be done. The radiologists are able to see heart size and can detect calcifications in the coronary arteries when present. It also can detect abnormal dilatations of the main blood vessels leading out of the heart. These results will be reported to your doctor.
The benefits of lung cancer screening CT scans are highest for those with significant lung cancer risk.
The I-ELCAP research has focused on patients at a high risk for lung cancer. Several factors contribute to lung cancer risk: age; smoking history; environmental exposure to carcinogens like asbestos, beryllium, uranium, or radon; and exposure to second hand smoke. The older you are, and the more you've smoked or been exposed to smoke and other carcinogens, the higher your risk will be.
Additionally, a recent I-ELCAP study showed that women were twice as likely as men to develop lung cancer when both had similar smoking histories. Click here for more information about how lung cancer affects women.
We encourage you to contact one of our member sites to make an appointment and learn more about how you personally may benefit from a lung cancer screening CT.
Risks associated with being screened include finding abnormalities that need additional tests and that are ultimately benign. These tests can cause anxiety and on some occasions lead to invasive procedures such as biopsy to further determine whether a finding is a cancer. The I-ELCAP protocol has been frequently updated over the past 14 years to keep these risks at a minimum. This should be discussed with your doctor for further information.
If you are interested in being screened, we recommend that you discuss the risks and benefits with your doctor so that it is a shared decision. If you do decide to undergo screening, please call the coordinator at your nearest member institution. We ask that you be prepared to give the following information:
- Your name, address, phone number, birth date, and parent’s first names for registration purposes.
- A time convenient for you to schedule an appointment.
The times will vary from site to site. Currently, most sites offer some evening and weekend appointment in addition to daytime slots.
The actual CT scan takes only about 5 minutes in total (with set up and scanning time). You are only scanned for less than 20 seconds, while you hold your breath. The registration and interview with the Coordinator may add an additional 25-30 minutes to your visit. We recommend setting aside one hour of your schedule for this appointment, even though it is unlikely that the entire hour will be necessary.
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Have questions? Contact us by email, telephone or mail.
If you're ready to talk about getting screened, or to make an appointment with a doctor in your area, search our list of member sites to find the location nearest you.
I-ELCAP would like thank Idologic, Inc., for its donation of hosting and support services.