Albert Rizzo, MD, on Screening for Lung Cancer

In this 3-minute video, Albert Rizzo, MD, talks about screening for lung cancer, who should be involved in a multidisciplinary team approach to lung cancer screening, and how national organizations are helping to widen the screening eligibility criteria.

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Albert Rizzo, MD, is the chief medical officer for the American Lung Association.



I’m Dr Albert Rizzo. I'm the chief medical officer for the American Lung Association.

I think besides the pulmonologist and specialist, it also includes the primary care physicians and the nurse practitioners who often see these patients upfront. This is the population of physicians who will be making decisions about lung cancer screening. They'll have the discussion with their patients with regard to their eligibility based on pack years that they've smoked and their age to promote lung cancer screening as a way to diagnose lung cancer early.

Unfortunately, pulmonologists and other specialists don't get involved until that scan is done and an abnormality is seen, or if a scan is done for unrelated reasons such as abdominal pain, a lung nodule is seen. It's the earlier detection that then drives these patients to be identified as having a problem, and hopefully then the treatment will be appropriate.

If it's early stage lung cancer, surgery can often be an option, which is curable. If it's farther along, certainly getting them to the oncologist quicker. Goals of many of the lung cancer specialists are to decrease the time from diagnosis to treatment—getting that down to about 2 to 3 weeks. The most right now probably stands at 2 to 3 months in many places.

As far as the pulmonologist and other specialists, I think it's growing realization that using a multidisciplinary team to come up with approaches to lung cancer is the best. Not only to help with what's the best way to diagnose a nodule that’s seen on a scan, but once a diagnosis is made to determine what are the best options for treatment.

We now have much better treatments with regard to—Besides surgery, we now have options, such as long-time chemotherapies. We also now have targeted mutation therapy, as well as immunotherapy that can make a big difference in patients if it's identified upfront that they have these specific mutations.

One of our main messages from the Lung Association is that when screening got put into place by the United States Preventive Services Task Force back in 2015 and since then, there's still been a very low uptake of eligible people getting scanned. I think the most recent estimates are in the 2% to 3% range, maybe up to 4% or 5% depending on who you read.

But the more people we can get into that eligibility group who gets scanned, the better. We also realize that the USPSTF has actually come up with a new recommendation. It's not in place yet, but their draft recommendation is to lower the number of pack years needed down to 20 pack years and the lower the age to 50 years.

By doing that, that may significantly—well, not may. It will significantly increase the number of individuals who fit into that eligibility to get screened. We've been promoting getting screened by the Saved by the Scan campaign that we've had for the last 3 years. More patients are going to that website, taking the eligibility quiz, and hopefully then going to the doctors and talking about getting screened.