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VICC debuts lung cancer screening program

Jan. 30, 2014, 9:53 AM

Otis Rickman, D.O., left, and John Worrell, M.D., are co-directors of Vanderbilt-Ingram Cancer Center’s new lung cancer screening program. (photo by Susan Urmy)

Vanderbilt-Ingram Cancer Center has launched a new lung cancer screening program to provide low-dose CT scans for patients at high risk for the deadly disease. Current or former smokers ages 55 to 74 who have a history of 30 or more pack years of smoking are eligible for the scans.

A pack year is defined as the equivalent of smoking one pack of cigarettes a day for a year or the number of packs per day times the number of years smoked. For example, one pack a day for 30 years, or two packs a day for 15 years would each equal 30 pack years.

Individuals who quit smoking more than 15 years ago are considered at lower risk and are not eligible for the new Vanderbilt screening clinic.

Otis Rickman, D.O., assistant professor of Medicine and Thoracic Surgery and co-director of the new clinic, said the goal of the program is to save lives.

“The reason to screen is that lung cancer has no symptoms early on and once it has symptoms and is at an advanced stage it is typically not curable,” Rickman explained.

Only about 15 percent of patients diagnosed with lung cancer are still alive after five years and the disease is still the biggest cancer killer of both men and women in the United States.

The benefit of screening a specific group of high-risk patients was confirmed by the National Lung Screening Trial (NLST), which randomized more than 53,000 current or former heavy smokers to receive three annual low-dose spiral CT scans or a standard chest X-ray. The study found a 20 percent reduction in deaths from lung cancer among patients who received the CT scans.The study, published in 2011, was funded by the National Cancer Institute, a division of the National Institutes of Health.

John Worrell, M.D., professor of Radiology and Radiological Sciences and chief of Thoracic Radiology, was Vanderbilt’s principal investigator for the NLST.

“Nearly 160,000 patients die from lung cancer every year, and if we can save 20 percent of those patients through screening, that’s a big number,” said Worrell, who is also the co-director of the new program.

Worrell emphasized that the best way for patients to reduce their lung cancer risk is to stop smoking.

The low-dose CT scans are quick and painless. They do not require a needle stick; patients don’t have to swallow anything and the scan takes just a few minutes. The radiation dose is similar to a mammogram or six to 12 months of natural, environmental radiation exposure.

Worrell said smokers and ex-smokers who are at high risk should start adding an annual CT scan to their list of cancer prevention strategies.

Joe B. Putnam Jr., M.D., Ingram Professor of Surgery and chair of the Department of Thoracic Surgery, treats patients with early-stage lung cancer.

“The lung cancer screening program will identify asymptomatic patients with early-stage lung cancer. Treatment with minimally invasive surgery can be curative for these patients,” explained Putnam. “If you are currently smoking you need to quit and you may need to get screened.”

VICC has set a goal of making the screening test as accessible as possible, so the out-of-pocket cost to patients is $199. At the moment, Medicare and private insurance companies do not pay for the test.

However, the U.S. Preventive Services Task Force recently issued a recommendation for the CT scans for high-risk patients and this could eventually lead to insurance coverage for the test.

The CT scans are offered on an outpatient basis at four Nashville-area locations — Vanderbilt Medical Center Imaging, One Hundred Oaks Imaging, Cool Springs Imaging and Hillsboro Imaging.

Patients whose scans reveal a suspicious nodule in the lung will be referred for follow-up care to VICC’s multidisciplinary team of lung experts.

To find out if they qualify for the diagnostic tests and to make an appointment, patients may call 936-8422 or toll-free (877) 936-8422. For more information, visit

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