CT Lung Cancer Screening

CT Lung Cancer Screening

CT Lung Cancer Screening - Information for Patients & Families (pdf)

Patient Story part 1

Introduction

Patient Story part 2

Lung cancer remains the leading cause of cancer-related deaths in the United States.

In June 2011, the New England Journal of Medicine published results from the National Lung Cancer Screening Trial (NLST) that showed a 20% mortality reduction in a high-risk population who had been screened using low-dose CT as compared to a control group screened using chest radiography. NLST is the first lung cancer screening trial to demonstrate such a mortality benefit.

Patient Story part 3

In October 2011, the National Comprehensive Cancer Network (NCCN) issued guidelines recommending low-dose CT screening for lung cancer.

Stanford Medicine Imaging will be offering this screening test to patients who meet the criteria used either in NLST or recommended in the NCCN guidelines. (See Exam Eligibility section)

Currently, CT screening for lung cancer is not covered by insurance. Eligible patients must be referred by a physician. Active smokers undergoing screening CT should enter a smoking cessation program. Screening is not an alternative to smoking cessation.

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Left: 65 year-old woman

Right: Eight months later

False Positives

Over the period that NLST participants were screened, approximately 40% of individuals had a positive CT result, usually consisting of small indeterminate pulmonary nodules considered suspicious for lung cancer, on at least one of the three annual tests. These findings required diagnostic follow-up, mostly with further imaging, and in some cases invasive procedures such as bronchoscopy or percutaneous biopsy. Of these initial findings, 96.4% were false positives. The rate of complication during follow-up of the CT group was 1.4%. The rate of major complication was 0.06% in the false positive group and 11.2% in those with lung cancer. Of the cancers detected, most were adenocarcinomas, many of which were detected at stage I or II. The death rate from any cause in the CT screening group was reduced by 6.7%, compared to the radiography group. One death from lung cancer was prevented per 320 participants in screening.

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Suspicious Nodules

If a suspicious nodule is identified on a screening CT, patients and their referring physician can be provided a list of Stanford physicians with expertise in the further evaluation and management of such nodules – including pulmonologists and thoracic surgeons. The patient may then make an appointment with one of these individuals to determine any appropriate additional steps to be taken.

Lung Nodule Clinic - Lung Cancer
Tel Work (650) 725-7061 Fax (650) 498-6288
http://pulmonary.stanford.edu
Dr. Daya Upadhyay

Division of Thoracic Surgery
(650) 721-2086 or (650) 736-7191
http://thoracicsurgery.stanford.edu

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Radiation Dose Reduction and Optimization

At Stanford Medicine Imaging, we understand that radiation exposure is a concern to referring physicians and patients. We are committed to reducing radiation exposure and follow radiation safety principles. CT lung cancer screening will be a low-dose CT exam, with a radiation dose of approximately 1.5 mSv (millisieverts), equivalent to approximately half of the naturally occurring background radiation that a person receives for one year at sea level. This exam does not require intravenous contrast.

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CT Scan

CT Lung Cancer Screening is a low-dose CT exam, with a radiation dose of approximately 1.5 mSv (millisieverts), equivalent to approximately half of the naturally occurring background radiation that a person receives for one year at sea level.

What Will Happen during the CT Examination?

The CT scanner is a large machine with a hole, or tunnel, in the center. You will lie on a table that slides into and out of this donut-shaped hole or tunnel. Your caregiver will sit behind a window during the CT scan; however, your caregiver will be able to see, hear, and speak with you at all times. You may be asked to change into a hospital gown and to remove all jewelry, earrings, or other metal objects. Caregivers will help you lie down on the CT scan table. The body part being tested may be kept in place with a cradle or straps to hold it very still. Special lights may be used to make sure that you are properly positioned. You will be asked to hold your breath during the scanning. You must lie very still during the scan. If you move, the CT scan pictures may not be clear.

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Exam Eligibility

NLST Guidelines:

NCCN Guidelines:

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Exclusion Criteria for Study

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Exam Preparation

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Resources

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Patient Financial Services Letter

Thank you for your interest in scheduling a CT Lung Cancer Screening Study at Stanford Hospital & Clinics. This letter is to provide you with important information related to the charges and billing for your services.

Please be advised there is a hospital fee and a separate physician fee associated with this service. If your insurance plan provides coverage, you will be responsible for any remaining balances after insurance pays its portion, including any deductible or coinsurance amounts applied.

There are some insurance plans that do not cover CT Lung Cancer Screening. Therefore, if you receive a notice of non-coverage denial from your insurance plan, a discount off the total charges is available to you upon request. This is subject to change without notice. Please see below the final cost to you with the discount applied:

CT Lung Cancer Screening
  Fee Less Discount
Hospital $420.00
Physician $75.00
Total Patient Responsibility $495.00


Should you have these services and your insurance does not provide you with coverage, please call Customer Service at (800) 794 8978, Monday-Friday 8:00am-4:00pm to request your discount as outlined above.

To schedule this service, please contact our Radiology Scheduling Center at (650) 723-6855, Monday-Friday 7:30am-6:00pm. We look forward to the opportunity of providing you the best in care and service.

Sincerely,
Patient Financial Services

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