1. Introduction
Lung cancer develops when the cells inside the lungs divide uncontrollably and form tumors while destroying healthy lung cells. This cancer is considered one of the leading causes of cancer-related deaths and contributes to around 1.8 fatalities across the globe every year. The prevalence of lung cancer is also increasing in India where almost 75, 000 new cases are seen annually as reported by ICMR (Indian Council of Medical Research). The increasing numbers of this cancer especially among men makes early detection extremely important.
Early detection of lung cancer is one of the most important steps that will help in increasing survival rates. Additionally, it also plays a vital role in providing timely intervention which further increases the effectiveness of the treatment plan. Through this elaborate guide, a detailed overview of lung cancer screening services in India will be given along with its eligibility criteria, types, benefits, and procedural details.
2. What is Lung Cancer Screening?
Lung cancer screening is a combination of diagnostic tests that are done for patients who are at high risk of developing lung cancer. This test can be conducted on those who haven’t even started experiencing any symptoms of lung cancer symptoms. The main aim of this screening is to identify the growth of cancerous growth in the lungs at an early stage so that the survival rates and efficiency of the treatment can be improved.
Who should consider screening?
Lung cancer screening is considered beneficial for individuals who are at high risk of suffering from lung cancer due to family history, smoking habits, age, or other environmental factors. Some of the cases when an oncologist can recommend cancer screening are-
- Heavy smokers: If you have been smoking tobacco for several years then screening is advised.
- Age: People who are between 50 and 80 years old with a smoking history can undergo screening.
- Family history: If any member of your family is suffering from lung cancer then you may also have that genetic predisposition. In such cases, you need to undergo a screening.
- Smoking history: People who have quit smoking but have a smoking history for the past 15 years need screening.
3. Importance of Early Detection
There are various importance of early detection in lung cancer as it helps detect early-stage lung cancer. In India, the survival rates with lung cancer are considered low and the cancer being detected at a later stage can be the main reason. If the cancer is successfully detected early then it can contribute hugely to higher survival rates and a successful recovery.
Statistics on survival rates with early detection
The 5-year survival rate for non-small cell lung cancer that is localized is around 65% and this rate significantly drops to 37% and 9% for regional and distant stages respectively. However, if cancer screening is done then the cancer can be detected in early and localized stages which will surely have a positive impact on survival rates. According to various research, it has been seen that through low-dose CT screening for lung cancer, a 20-year survival rate can be increased to around 80%. It is important to note that cancer screening will not prevent the cancer from developing but it will improve survival rates and overall life quality.
How screening helps in reducing mortality rates
According to the National Lung Screening Trial (NLST), it has been determined that cancer screening can reduce mortality rates related to lung cancer by around 20%. The main reason behind this reduced mortality rate is early detection of the disease at initial stages through Low-dose CT scans for lung cancer. Herein, it must be noted when the small tumors in the lungs are detected then effective and timely treatment can be provided which will further reduce the risk of death.
4. Types of Lung Cancer Screening Tests
To make early detection easier, there are various available types of lung cancer screening tests. The most recommended tests that you can undergo are low-dose CT scans. Other common tests include chest X-rays, PET scans, and sputum cytology. Let us now explore the most common screening tests in detail-
- Chest X-rays
For many years, chest X-rays have been used to detect lung cancers. However, this procedure of assessing the organs and bones in the chest can be less effective in identifying early-stage lung cancers as the small tumors may not be clearly visible in the X-rays. This is why, nowadays doctors don’t rely upon X-rays for early screening and don't consider it as the primary screening process.
- PET CT Scans
PET or positron emission tomography scans can be done after a CT scan to compare the results to get a better analysis. In this scan, a radioactive form of sugar is injected which is then collected by the cancer cells. This is an effective way to see the presence of cancerous cells in the lungs.
- Low-dose CT (LDCT) scans
One of the most common and effective cancer screening methods is low-dose CT scans for lung cancer. In this test, a lower dose of radiation is used to spot any small tumors in the lungs. Through this method, the cancerous tumors can be identified at an early stage.
Why is LDCT the gold standard for screening?
LDCT is considered the gold standard for lung cancer screening as the results of this test are highly sensitive and accurate as compared to chest X-rays. The lung cancer that might have been overlooked by other procedures can be easily detected with this test. As a result, it contributes to 20% reduced mortality rates related to lung cancer among the high-risk population. To undergo this test, you can visit Hope & Heal Cancer Hospital and Research Centre, which is regarded as the top cancer hospital in Siliguri.
5. Eligibility Criteria for Lung Cancer Screening
Lung cancer screening is definitely a great way to take proactive and early measures to cure lung cancer while detecting the signs even before they show up. However, not everyone can undergo this screening on their own.
The American Cancer Society has fixed specific eligibility criteria which helps in determining the individuals who need to undergo the screening. There are certain high-risk categories based on which a patient can be recommended for the screening procedure. The criteria include-
- Age: One of the most common factors that helps in determining the need for cancer screening is age. If the person is aged between 55 and 74 years and has a history of smoking then screening is needed.
- Long-term smokers: If you were a long-term smoker with a history of 30-pack-years then you need a screening. Whether you’re still smoking or have quit in the last 10-15 years, you will be recommended for screening.
- Family history of lung cancer: The Lung cancer screening eligibility criteria also include family history. Herein, you can undergo the screening if one or more family members are suffering or have died due to lung cancer.
- Overall good health: For lung cancer screening, you need to be in fairly good health. Herein, you shouldn’t have any serious health issues or symptoms of lung cancer.
6. How to Prepare for a Lung Cancer Screening
What to expect before the test?
When the doctor recommends lung cancer screening, the first thing that will come to your mind is “How to prepare for a lung cancer screening”? Herein, before the test, you may expect an initial consultation with the oncologist. In this consultation, your family and medical history will be reviewed by the doctor. This will help in determining whether you fall into the eligibility criteria or not. If you have any doubts about the preparation steps then you can ask the doctor in this consultation.
Tips for a smooth screening process
- Understand the process: For a smooth screening process, you need to understand everything about the test. Herein, you must know that an LDCT scan is a non-invasive test that only takes a few minutes to complete. For the test, you will be directed to lie down and then the table will be moved into the scanner for taking clear images of the lungs.
- No special preparation required: You do not need any special preparation for under LDCT scan. However, the doctor may recommend stopping drinking or eating heavy foods before a while of the scan. For clear images, you can also be asked to hold your breath for a while.
7. Benefits of Lung Cancer Screening
Before undergoing cancer screening, it is vital for you to understand the possible risks and benefits of lung cancer screening. As mentioned earlier, the main benefit of lung cancer screening is to identify the cancer at an early stage. Along with this, there are other specific benefits of the screening, which include-
- Increased chance of curative treatment: You have higher chances of a successful cure from the cancer if you undergo cancer screening. This is mainly possible because screening helps in early detection and timely treatment that may include chemotherapy or surgery.
- Improved quality of life: If the cancer is diagnosed at an early stage then the likelihood of successful treatment increases. This further leads to improved survival rates and quality of life.
- Peace of mind: The continuous anxiety and stress of being diagnosed with lung cancer can be reduced if you schedule routine lung cancer screening. This proactive step in managing your lung health can ensure you peace of mind.
8. Risks and Limitations of Lung Cancer Screening
As you now know the benefits of lung cancer screening, you must also understand the limitations and risks associated with it. This will help you make an informed decision about the screening procedure-
- Possible false positives and false negatives: In some cases, lung cancer screening can produce false negative or false positive results. If the report indicates a false positive then it will lead to unnecessary treatments and tests which is a waste of time and money. On the other hand, false negatives can delay the treatment while decreasing survival rates.
- Risks of radiation exposure: It is true that the radiation used in LDCT is extremely low but continuous scans over time can lead to various side-effects. Due to this radiation exposure, you may have a high risk of developing radiation-induced cancers.
- Over-diagnosis concerns: In some scenarios, there can be certain slow-growing tumors in the lungs that may have imposed no harm or showcase any symptoms. However, due to the screening tests, you can be advised of some unnecessary treatments for this that can cause emotional and physical distress.
9. Cost of Lung Cancer Screening
As compared to the western countries, the cost of lung cancer screening in India is lower which makes it affordable and well-accessible by a larger population. Herein, the approx. The price of LDCT scan in India can be around between INR 2,000 and 5,000.
However, this cost can vary based on certain factors such as location and type of the scan. In some cases, certain advanced centers and reputed hospitals can also charge you more. On the other hand, the cost of the same test in the US can be a bit expensive, ranging between $100 and $400.
- Government programs: As an initiative to spread lung cancer awareness, the Indian government has developed various programs for lung cancer screening. There are certain state-run clinics and hospitals where you can get screening programs free of cost, especially for the people who meet the eligibility criterion. These programs play a vital role in reducing the rates of lung cancer in India.
- Insurance coverage: To cover the cost of lung cancer screening, you can also seek assistance from private health insurance policies. However, you must note that this coverage is only available for high-risk populations. You must always consider visiting a cancer hospital before undergoing the test.
10. Guidelines for Lung Cancer Screening
Various international and Indian health organizations such as the American Cancer Society and Indian Council of Medical Research (ICMR) have developed certain screening guidelines for lung cancer. Some key recommendations mentioned by these organizations are-
- Yearly lung cancer screening for individuals aged between 50 and 80 years with a low-dose CT scan. This screening frequency is applicable for people with a smoking history of 2- pack-year.
- The screening can only be done for individuals who have good overall health conditions. It shouldn’t be recommended to those who have underlying serious health issues or symptoms of lung cancer.
- The annual lung cancer screening must be stopped for people who have crossed the age of 80.
- People with less low probability of lung cancer can consider the screening interval of 1-2 years.
11. Preventive Measures Beyond Screening
Along with regular screening, the doctor might recommend certain preventive measures that will help in reducing the likelihood of lung cancer. Lung cancer prevention and screening strategies together can enable you to live a cancer-free life. Some of the lifestyle modifications that you can make to prevent lung cancer are-
- Smoking cessation: One of the most vital steps to prevent lung cancer is to spot smoking. You must note that smoking is considered the most prevalent reason behind the increasing rates of lung cancer in India.
- Avoiding pollutants and carcinogens: There are various environmental toxins and pollutants causing lung cancer. This is why it is vital for you to avoid carcinogens and pollutants that include industrial chemicals, air pollution, and second-hand smoke.
- Maintaining a healthy diet: To prevent lung cancer, you must always prioritize a healthy lifestyle. A diet rich in whole grains, fresh fruits, and vegetables can reduce the risk of cancers.
- Exercise regimen: To maintain your lung and overall health, you should make exercise a regular habit. If you are indulged in routine physical activity then you can prevent cancer.
12. How to Find the Right Screening Center
To get accurate results for lung cancer screening, it is extremely essential for you to choose the right screening centre. Here are some of the factors and tips that you can consider to select the best clinic:
- Check reviews: Before selecting a centre, you must always research and look for recent patient reviews. This will help you understand the facilities and success rates of the screening techniques.
- Seek recommendations: If you have no idea about the reputed clinic then don’t hesitate to seek recommendations from those who have already undergone the screening. You can also communicate with your physician, friends, or family members for recommendations.
- Assess the specialists: Choosing the right centre is not only essential, but it is also vital for you to check whether the clinic has trained oncologists or radiologists or not. This is vital because these specialists are responsible for performing and assessing the test results.
- Make a list of accredited centres: To know about the available options, make a list of the accredited centres in your location. It is always a safe option to select a centre that has been accredited by the National Accreditation Board for Hospitals & Healthcare Providers (NABH).
13. FAQs on Lung Cancer Screening
Can non-smokers undergo lung cancer screening?
Yes, non-smokers who have been exposed to certain carcinogens or have a family history of cancer can consider undergoing lung cancer screening. However, it is always recommended to consult a doctor before undergoing the screening.
How long does a screening take?
An LDCT scan often takes a few minutes to complete. You can expect the entire process to be completed within half an hour.
What happens after a positive screening result?
If the lung cancer screening test showcases positive results, then you must not delay contacting a reputed oncologist. The doctor will advise you to undergo more diagnostic tests such as imaging or biopsy to confirm lung cancer diagnosis.
14. Conclusion
To prevent lung cancer from spreading, lung cancer screening can be considered the most important and powerful tool. By undergoing lung cancer screening, you can attain increased survival rates with improved treatment outcomes. While it is not recommended for everyone if you’re in the high-risk category then you must not delay and undergo the tests immediately. Remember that by adopting preventive measures and scheduling routine check-ups, you can reduce the likelihood of suffering from lung cancer. Consult an experienced oncologist today for personalized advice.
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