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Lung Cancer Screening

Lung cancer is the number 1 cancer killer in the U.S.

Screening and early detection of lung cancer offers the best chance to detect lung tumors that are smaller, more localized and have not spread to other organs, thereby offering the best chance for a longer term survival and possible cure.

Routine chest x-rays are invaluable for the diagnosis and management of lung disease, however prior clinical studies using regular chest x-ray imaging have failed to show a benefit in reducing lung cancer mortality.  This suggests that chest x-rays are not sufficiently sensitive for detecting smaller lung tumor nodules.

In late 2011, the National Cancer Institute announced the results of a clinical lung cancer screening study using low dose spiral chest CT scans. This study demonstrated a 20% reduction in lung cancer mortality in high-risk patients receiving CT scan screening confirming an important role for early detection and treatment of patients with lung cancer.

Benefits of CT scan screening of lung cancer:

1. Early detection and prevention of death from lung cancer.

Potential harms of CT scan screening:

1. Small and unexpected lung nodules are often detected by routine chest CT scans.  Most of these nodules are not malignant tumors.  You need an expert team of physicians and surgeons to guide the patient through the process of evaluating lung nodules of indeterminate significance to minimize harm to the majority of subjects who do not need treatment for lung cancer.
2.  A diagnostic lung biopsy can result in unintended risks to the health of the normal lung.  Therefore, the decision to undergo a biopsy requires skill, experience, and close communication between a team of thoracic radiologists, pulmonary doctors, thoracic surgeons, medical oncologists, radiation oncologists,and thoracic pathologists.
3. Over time, the cumulative health effects of small doses of radiation from a large number of diagnostic radiology studies is unknown.

Due to these concerns, lung cancer screening is recommended only for individuals who are at a higher risk for the development of lung cancer – The criteria for the University of Florida at Shands are individuals who are:

1. between the ages of 55-74, AND
2. smokers with at least a 30 “pack year” smoking history (for example, 1 pack per day for 30 years 1 x 30= 30 pack years; or 2 packs per day for 15 years 2 x 15= 30 pack years), AND
3. If a former smoker, must have quit within the past 15 years, AND
4. If you have less than 30 pack years of smoking history, or quit more than 15 years ago, but you have another risk for lung cancer [prior lung or head and neck cancer, family history of lung cancer, lung exposure to known carcinogen (not second hand smoke), or COPD/emphysema]

Recommendations and guidelines for Lung Cancer Screening are still under consideration at many national cancer societies.  These recommendations will ultimately impact on the decision of Medicare, Medicaid, and private insurance companies to cover the cost of these studies.

In summary, lung cancer screening is a complex process.

The University of Florida at Shands offers a multidisciplinary team of physicians and surgeons who are in close communication and who meet throughout the week to:
1. minimize invasive lung biopsy procedures to protect normal lung health
2. minimize radiology testing to limit radiation exposure to each patient
3. for those patients who need a diagnostic procedure, the University of Florida at Shands offers a nationally recognized team of physicians and surgeons to offer the latest diagnostic tools and methods including navigational and interventional bronchoscopy, interventional radiology guided biopsy techniques, non-invasive thoracic surgery, and Stereotactic radiosurgery

The University of Florida at Shands
1. is the recognized leader in navigational and interventional bronchoscopy for the state of Florida.
2. is the inventor and holds patents for stereotactic radiosurgery.
3. is a leader in non-invasive thoracic surgery.

We have a one-site clinic where patients are evaluated during the same visit by multiple team members.  A dedicated nurse coordinator/navigator helps each new patient through this process to make sure they are scheduled with the required team members which can include pulmonary medicine, thoracic surgery, medical oncology, and radiation oncology in the same visit.

We discuss all patients every week in a multidisciplinary conference that includes a team of thoracic radiologists, pulmonary doctors, thoracic surgeons, medical oncologists, radiation oncologists,and thoracic pathologists.

The University of Florida at Shands is a tertiary university medical center that offers state of the art low-dose spiral CT screening with a dedicated team to evaluate all lung abnormalities, make recommendations, and communicate closely with patients and referring physicians.

All spiral low dose CT lung cancer screening will be performed at Shands Hospital in Gainesville, and will be read by a dedicated thoracic radiologist .

Currently the procedure is not covered by the majority of insurance plans. To obtain a lung cancer screening test or to get more information please call (352) 265-0649.


Tobacco cessation is an important component of any lung cancer screening effort and we offer information and resources to all patients seen in our clinic. Get help to quit smoking.