Dr. Rivera on Screening in Lung Cancer

M. Patricia Rivera, MD, professor of medicine, UNC Chapel Hill, UNC Lineberger Comprehensive Cancer Center, discusses the recent adoption of lung cancer screening into clinical practice.

Screening came about following the publication of The National Lung Screening Trial. The randomized trial compared CT scan with chest X-ray in smokers over the age of 55 with a 30-year smoking history. The trial demonstrated the first reduction in mortality for patients who had been screened with CT scan.

In 2014, the United States Preventative Task Force gave this a B recommendation. In 2015, Medicare approved screening, and since then it has become more available. However, it is considerably underutilized, says Rivera. As of 2015, only 3.9% of eligible patients were being screened in the United States. This may be due, in part, to the difficulty of getting an accurate smoking history.