Lung cancer is the leading cause of cancer death, accounting for one in five deaths from all types of cancer.
And the sad thing about that statistic, says Dr. Dennis Oyieng’o, is that lung cancer is curable if caught in its early stages. Tragically, it is seldom caught early, partly because there are rarely any symptoms in early stages and people at high risk are not aware that there are screening tests that could save their lives.
“The one thing that can save more lives than anything else is information,” the Kenyan native says. “People need to understand the risk factors and know that screening is available.”
Oyieng’o, a pulmonology specialist with Ascension Via Christi, is a member of a multi-disciplinary team working to catch lung cancer at earlier stages when it is curable. The low-dose CT Lung Screening Program is able to detect Stage 1 lung cancer, and the team can move quickly to perform additional diagnostic testing, including Nodify, a newly available blood test to determine the likelihood of a nodule being cancerous.
He said that information is especially important for African Americans because lung cancer is often diagnosed at later stages in Black people and the overall survival rate is lower.
“And, sadly, the number of people who don’t get treatment at all is much higher in Black people than in White people,” he said.
The high risk criteria
Any person who meets the criteria for being considered at high risk for developing lung cancer should get the early detection scan, he said. Those criteria are:
- Being between the ages of 50 and 80; the age when cancer is most likely to develop.
- Having smoked the equivalent of a pack an day for 20 years or two packs a day for 10 years;
- Being an active smoker or having quit smoking in the last 15 years. When you quit smoking the risk of cancer slowly lessens so that after 15 years, you are likely on par with the general population.
The scan is covered by most insurance companies and Medicare and Medicaid (KanCare in Kansas). For those who meet the criteria but have no insurance, the team includes a member who helps patients find programs that will pay for the screening.
Why the Racial Disparity in Lung Cancer
Oyieng’o said there are a number of reasons for the racial disparity in cancer deaths.
“Overall, there is less access to regular medical care. Black people are more likely to be uninsured and less likely to have a primary care doctor. Black people are more likely to be smokers and to be less successful at quitting. We know that smoking is the leading cause of lung cancer. Tobacco affects the DNA of the smoker and damages the lung cells, increasing the development of abnormal cells,” he said.
There is also the issue of environmental injustice – Black people are more likely to live in areas where there are air or water pollutants that can increase cancer risks.
Oyieng’o said Ascension Via Christi has developed a multi-disciplinary team to try to increase early detection and treatment.
The Lung Nodule Clinic includes pulmonologists, interventional pulmonologists and cardiothoracic surgeons, oncologists and nurse navigators to help patients with scheduling or other issues.
“First, we do a low-dose CT scan,” Oyieng’o said. “Normal lung tissue appears dark on the scan. Abnormalities show up as light spots. Those spots can be from an infection. They can be scars from prior damage. Or they can be cancer. If we suspect a lesion is cancer, the next step would be a biopsy, then surgery to remove it.
The advantage of the multidisciplinary team is that all next-step providers are in the same place at the same time, so that instead of having to make a series of appointments with different providers at different offices, the patient can get everything done at one place. That not only saves time, but also eliminates the chance of missed appointments.