Dr. Stefaan Van de Perre Dr. An Belmans. Dienst Radiologie. H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel

Size: px
Start display at page:

Download "Dr. Stefaan Van de Perre Dr. An Belmans. Dienst Radiologie. H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel"

Transcription

1 Dr. Stefaan Van de Perre Dr. An Belmans Dienst Radiologie H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel 1

2 Background Screening trials harms and benefits Practical guidelines Take home messages 2

3 Background Screening trials harms and benefits Practical guidelines Take home messages 3

4 Leading cause of cancer related death in the US Poor prognosis : 5 year survival rate 15.6 % >< over 90 % for breast, colon and prostate cancer intrinsic aggressive biological behavior no screening => late diagnosis Smoking related % of cancers former smokers stay at increased risk, compared to nonsmokers Prevention : primary : smoking cessation secondary : screening 4

5 Background Screening trials harms and benefits Practical guidelines Take home messages 5

6 Goal : early detection before symptoms increased survival through detection at an early stage mortality reduction XR chest w/wo sputum cytology : no decrease in mortality Biological specimens : future Low dose MDCT : US and Europe trials NLST : only RCT in the US with adequate statistical power => results 2011 in the NEJM NELSON trial => results to be expected in

7 Randomized controlled trial (started 2002) High risk patients y-old 30 pack years of smoking former smokers : cessation < 15 years no history of lung cancer patients enrolled Low dose MDCT (average 1.5 msv) Control arm : chest x-ray Baseline, and annual exam for 2 additional years 5 FU afterwards Primary end-point : lung cancer mortality Other paramaters: overall mortality lung cancer incidence screening and treatment morbidity health care utilization, quality of life and cost-effectiveness => substudies 20 % reduction in lung cancer mortality in the LD MDCT group 7

8 8

9 9

10 Benefits : 20 % reduction in mortality 10

11 Benefits : 20 % reduction in mortality Harms : radiation exposure overdiagnosis indeterminate nodules cost 11

12 radiation induced cancer year delay 100 msv : life time risk of radiation induced cancer 1 % 1 msv => % cancer death NLST Screening 1.5 msv: 1 cancer death/2500 screened patients >< 1 prevented death for every 320 screened individuals younger patients and lower risk : trade-off could be less favorable PET/CT CT LDCT NLST LDCT iterative Chest x-ray 14 msv 8 msv 1.5 msv 0.1 msv 0.02 msv RADIATON DOSE no IV contrast administration 12

13 Benefits : 20 % reduction in mortality Harms : radiation exposure overdiagnosis indeterminate nodules cost 13

14 Overdiagnosis : detection of a malignant tumor which would not affect patient s life time if left untreated, due to competing causes of death (comoridity) indolent tumor 14

15 Benefits : 20 % reduction in mortality Harms : radiation exposure overdiagnosis indeterminate nodules cost 15

16 Spherical 4 mm of greater (NLST) Margin characteristics spiculated/lobulated smooth poorly defined indeterminant Attenuation soft tissue water fat calcified other ground glass opacity (GGO) mixed 16

17 benign malignant suspicious indeterminate nodule? 17

18 50 % of the smokers will have at least one nodule % will have a positive finding, with > 90 % will turn out to be benign (false positieve) after diagnostic work up FU with imaging stable over a 2 year period => benign GGO and mixed opacity => extended FU Eur Radiol (2012) 22: It can cause anxiety => quality of life FU with imaging or invasive procedures additional cost radiation exposure : not precisely quantifiable morbidity/mortality (very low => NLST) 18

19 No NLST guidelines Best practice multidisciplinary team indeterminate nodules : known problem in routine chest MDCT. Fleischner Society guidelines 2005 => reduction of overuse of short intervals (eg. 3 months) Radiology 2005; 237: studies => guidelines for FU in a screening population FU with low dose and unenhanced MDCT 19

20 Routine chest CT PET/CT Percutanous biopsy Surgical procedure 20

21 Benefits : 20 % reduction in mortality Harms : radiation exposure overdiagnosis indeterminate nodules cost 21

22 Cost/effectiveness Individual cost for the patient 22

23 Benefits : 20 % reduction in mortality Harms : radiation exposure overdiagnosis indeterminate nodules cost 23

24 SCREENING IF THE BENEFITS OUTWEIGHS THE HARMS 24

25 previous guidelines : no lung cancer screening American Cancer Society (ACS) American College of Chest Physicians (ACCP) American Society of Clinical Oncology (ASCO) National Comprehensive Cancer Network (NCCN) Benefits and harms of CT screening for lung cancer JAMA 2012; 307(22): Lung cancer screening, Radiation, Risks, Benefits, and Uncertainty JAMA 2012; 307(22): American Lung Association (ALA) American Lung Association. Providing guidance on lung cancer screening to patients and physicians American Association for Thoracic Surgery J Thorac Cardiovasc Surg 2012; 144:

26 Background Screening trials harms and benefits Practical guidelines Take home messages 26

27 Policy sphere Cost-effectiveness, including incidental findings Further studies Organized approach and quality metrics to the evaluation and management of findings : appropriate technology training and quality assurance nodule FU protocols structure of multi-disciplinary teams screening is no excuse to continue smoking => vigorous smoking cessation efforts must accompany CT screening 27

28 Practical interim -guidelines 28

29 LDCT screening should be offered to high risk persons meeting the NLST entry criteria : y-old 30 pack years of smoking/cessation < 15 years no history of lung cancer AATS and NCCN : additional entry criteria Other patients : no recommendation Counceling about the harms and benefits Annual LDCT screening Smoking cessation NO CHEST X-RAY 29

30 NLST ENTRY CRITERIA 50-y-old and 20 pack year and ONE additional factor : Radon exposure occupational exposure cancer history : lung cancer, lymphoma, cancers of the head and neck, smoking related aerodigestive cancers such as esophageal cancer family history of lung cancer COPD or pulmonary fibrosis 30

31 LDCT screening should be offered to high risk persons meeting the NLST entry criteria : y-old 30 pack years of smoking/cessation < 15 years no history of lung cancer AATS and NCCN : additional entry criteria Other patients : no recommendation Counceling about the harms and benefits Annual LDCT screening Smoking cessation NO CHEST X-RAY 31

32 32

33 33

34 34

35 LDCT screening should be offered to high risk persons meeting the NLST entry criteria : y-old 30 pack years of smoking/cessation < 15 years no history of lung cancer AATS and NCCN : additional entry criteria Other patients : no recommendation Counceling about the harms and benefits Annual LDCT screening Smoking cessation NO CHEST X-RAY 35

36 Background Screening trials harms and benefits Practical guidelines Take home messages 36

37 Never start or quit smoking NLST => LDCT can reduce lung cancer mortality (20 %) (Interim) guidelines recommendation : no screening => screening high risk patients benefits >>> harms Counceling : prevalence and FU of indeterminate nodules No chest X-ray 37

38 38

39 Cost/effectiveness Screeningpopulation? Duration of screening? Time interval? Reducing false positive results? 39

Low-dose CT Imaging. Edgar Fearnow, M.D. Section Chief, Computed Tomography, Lancaster General Hospital

Low-dose CT Imaging. Edgar Fearnow, M.D. Section Chief, Computed Tomography, Lancaster General Hospital Lung Cancer Screening with Low-dose CT Imaging Edgar Fearnow, M.D. Section Chief, Computed Tomography, Lancaster General Hospital Despite recent declines in the incidence of lung cancer related to the

More information

Lung Cancer Screening Insights from the NLST Benefits, Harms and Unresolved Issues

Lung Cancer Screening Insights from the NLST Benefits, Harms and Unresolved Issues Lung Cancer Screening Insights from the NLST Benefits, Harms and Unresolved Issues Christine D. Berg, MD Co-Principal Investigator NLST Adjunct Professor Department of Radiation Oncology and Molecular

More information

Lung Cancer Screening

Lung Cancer Screening Lung Cancer Screening Middlesex Hospital Total Lung Care Center Megin Iaccarino RN, BSN Lung Pathway Coordinator and Lung Nurse Navigator Middlesex Hospital Cancer Center and Surgical Alliance Lung Screening

More information

Lung Cancer Screening

Lung Cancer Screening Scan for mobile link. Lung Cancer Screening What is lung cancer screening? Screening examinations are tests performed to find disease before symptoms begin. The goal of screening is to detect disease at

More information

Dorith Shaham, M.D. Department of Radiology Hadassah Hebrew Uviversity Medical Center

Dorith Shaham, M.D. Department of Radiology Hadassah Hebrew Uviversity Medical Center Dorith Shaham, M.D. Department of Radiology Hadassah Hebrew Uviversity Medical Center LUNG CANCER The most common fatal malignancy in the Western world Estimated 1.3 million deaths worldwide in 2000 In

More information

Stephen R. Veach, M.D.

Stephen R. Veach, M.D. Stephen R. Veach, M.D. Memorial Sloan-Kettering Cancer Center International Oncology Programs 160 E. 53 rd Street New York, NY 10022 212-610 610-08780878 - tel 212-308 308-7063 - fax veachs@mskcc.org SCREENING

More information

Lung Cancer Screening

Lung Cancer Screening Lung Cancer Screening Ted Yamamoto, Harvard Medical School Year III Case Presentation 67 year old male Hypertension, but otherwise healthy Smokes 7-87 8 cigarettes per day, >50 pack year history Here for

More information

MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock Manchester 100 Hitchcock Way Manchester, NH 03104 (603) 695-2850

MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock Manchester 100 Hitchcock Way Manchester, NH 03104 (603) 695-2850 LEBANON Lung Cancer Screening Program One Medical Center Drive Lebanon, NH 03756 (603) 650-4400 (866) 966-1601 Toll-free cancer.dartmouth.edu/lungscreening MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock

More information

An Update on Lung Cancer Diagnosis

An Update on Lung Cancer Diagnosis An Update on Lung Cancer Diagnosis Dr Michael Fanning MBBS FRACGP FRACP RESPIRATORY AND SLEEP PHYSICIAN Mater Medical Centre Outline Risk factors for lung cancer Screening for lung cancer Radiologic follow-up

More information

Low Dose Helical CT for Lung Cancer Screening

Low Dose Helical CT for Lung Cancer Screening Low Dose Helical CT for Lung Cancer Screening No Conflicts. No Disclosures. David K. Shelton UCDMC Lung Cancer Stages and Survival 213,000 new cases per yr #1 cause of cancer death 164,000 deaths/yr 5

More information

Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. Presenter: Jonathan E. Schwartz, MD

Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. Presenter: Jonathan E. Schwartz, MD Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening Disclosures: I, like many physicians, receive compensation from the government and their insurance company cronies who completely

More information

Lung Cancer Surveillance using low Dose CT scanning Where are We Now?

Lung Cancer Surveillance using low Dose CT scanning Where are We Now? Lung Cancer urveillance using low Dose CT scanning Where are We Now? cott wanson Professor Thoracic urgery Brigham and Women s Hospital and Harvard Medical chool Disclosures These slides were kindly provided

More information

Clinical Trials and Screening: What You Need to Know

Clinical Trials and Screening: What You Need to Know Scan for mobile link. Clinical Trials and Screening: What You Need to Know What is a Clinical Trial? At A Glance A clinical trial is a research study that tests how well new medical techniques work in

More information

WA Asbestos Review Program

WA Asbestos Review Program WA Asbestos Review Program Dr Fraser Brims Consultant Respiratory Physician, SCGH, Head of Occupational and Respiratory Health Unit, LIWA Asbestos awareness week seminar, 2014 Introduction Asbestos and

More information

Cancer Screening. Robert L. Robinson, MD, MS. Ambulatory Conference SIU School of Medicine Department of Internal Medicine.

Cancer Screening. Robert L. Robinson, MD, MS. Ambulatory Conference SIU School of Medicine Department of Internal Medicine. Cancer Screening Robert L. Robinson, MD, MS Ambulatory Conference SIU School of Medicine Department of Internal Medicine March 13, 2003 Why screen for cancer? Early diagnosis often has a favorable prognosis

More information

National Framework for Excellence in

National Framework for Excellence in National Framework for Excellence in Lung Cancer Screening and Continuum of Care declaration of purpose Rights and Expectations THE RIGHTS OF THE PEOPLE Lung cancer kills more Americans than the next four

More information

LOW DOSE CT LUNG CANCER SCREENING: IT S TIME HAS COME. Andrew D. Nish MD

LOW DOSE CT LUNG CANCER SCREENING: IT S TIME HAS COME. Andrew D. Nish MD LOW DOSE CT LUNG CANCER SCREENING: IT S TIME HAS COME Andrew D. Nish MD OBJECTIVES Understand the controversies of screening for cancer control in a large population Understand primary and secondary prevention

More information

LUNG CANCER SCREENING WITH LOW-DOSE CT ALYSSA CREWS, PA-S3 UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICINE PHYSICIAN ASSISTANT PROGRAM TULSA, OK

LUNG CANCER SCREENING WITH LOW-DOSE CT ALYSSA CREWS, PA-S3 UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICINE PHYSICIAN ASSISTANT PROGRAM TULSA, OK LUNG CANCER SCREENING WITH LOW-DOSE CT ALYSSA CREWS, PA-S3 UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICINE PHYSICIAN ASSISTANT PROGRAM TULSA, OK LEARNING OBJECTIVES 1. Describe current literature regarding

More information

Screening for asbestos-related lung cancer Nea Malila, Tony Miller, Riitta Sauni, Robert Smith, Kurt Straif, Tapio Vehmas

Screening for asbestos-related lung cancer Nea Malila, Tony Miller, Riitta Sauni, Robert Smith, Kurt Straif, Tapio Vehmas Screening for asbestos-related lung cancer Nea Malila, Tony Miller, Riitta Sauni, Robert Smith, Kurt Straif, Tapio Vehmas International Conference on Monitoring and Surveillance of Asbestos-Related Diseases

More information

Fact sheet Lung cancer screening for employees exposed to asbestos using CT screening (CTTS)

Fact sheet Lung cancer screening for employees exposed to asbestos using CT screening (CTTS) Version: February 2013 Fact sheet Lung cancer screening for employees exposed to asbestos using CT screening (CTTS) Dr. med. Susanna Stöhr, PD Dr. med. Dr. phil. David Miedinger, Dr. med. Marcel Jost 1.

More information

PROSTATE CANCER SCREENING PROSTATE CANCER SCREENING

PROSTATE CANCER SCREENING PROSTATE CANCER SCREENING 3:45 4:45pm Screening Guidelines for Men's Health SPEAKER Radha Rao, MD Presenter Disclosure Information The following relationships exist related to this presentation: Radha Rao, MD: No financial relationships

More information

September 26, 2014. Re: National Coverage Analysis for Lung Cancer Screening with Low Dose Computed Tomography (CAG-00439N) Dear Ms.

September 26, 2014. Re: National Coverage Analysis for Lung Cancer Screening with Low Dose Computed Tomography (CAG-00439N) Dear Ms. September 26, 2014 Tamara S. Syrek Jensen, J.D. Acting Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Mail Stop C1-09-06 7500 Security Boulevard Baltimore, MD 21244 Re:

More information

Low Dose CT Screening for Lung Cancer

Low Dose CT Screening for Lung Cancer Low Dose CT Screening for Lung Cancer Donna Edmondson, MSN, CRNP, AOCNP Division of Thoracic and Esophageal Surgery Fox Chase Cancer Center Philadelphia, PA Rohit Kumar, MD Assistant Professor of Medicine

More information

Screening High-Risk Populations for Lung Cancer

Screening High-Risk Populations for Lung Cancer Evidence-Based Series #15-10 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Screening High-Risk Populations for Lung Cancer H. Roberts, C. Walker-Dilks, K.

More information

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD Epidemiology, Staging and Treatment of Lung Cancer Mark A. Socinski, MD Associate Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive Cancer Center University of

More information

Biobanks associated to Cancer Screening Programs In Tuscany Francesca Carozzi. Analytical Cytology and Biomolecular Unit

Biobanks associated to Cancer Screening Programs In Tuscany Francesca Carozzi. Analytical Cytology and Biomolecular Unit Biobanks associated to Cancer Screening Programs In Tuscany Francesca Carozzi Analytical Cytology and Biomolecular Unit Bio-banks: Investments into Society The Public health care system is in great need

More information

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200

Disease/Illness GUIDE TO ASBESTOS LUNG CANCER. What Is Asbestos Lung Cancer? www.simpsonmillar.co.uk Telephone 0844 858 3200 GUIDE TO ASBESTOS LUNG CANCER What Is Asbestos Lung Cancer? Like tobacco smoking, exposure to asbestos can result in the development of lung cancer. Similarly, the risk of developing asbestos induced lung

More information

Analysis of Prostate Cancer at Easter Connecticut Health Network Using Cancer Registry Data

Analysis of Prostate Cancer at Easter Connecticut Health Network Using Cancer Registry Data The 2014 Cancer Program Annual Public Reporting of Outcomes/Annual Site Analysis Statistical Data from 2013 More than 70 percent of all newly diagnosed cancer patients are treated in the more than 1,500

More information

Management of GGO and Other Lesions Found on Screening CT Scan

Management of GGO and Other Lesions Found on Screening CT Scan Management of GGO and Other Lesions Found on Screening CT Scan AATS/STS General Thoracic Surgery Symposium American Association for Thoracic Surgery San Francisco, CA April 2012 David R. Jones MD George

More information

Oncology Update. Franklin Chen, MD. Novant Health Oncology Specialists. Making healthcare remarkable

Oncology Update. Franklin Chen, MD. Novant Health Oncology Specialists. Making healthcare remarkable Oncology Update Franklin Chen, MD Novant Health Oncology Specialists Making healthcare remarkable Disclosures Speakers Bureau Onyx Principal Investigator BMS, Genetech, EMD Serono, Incyte Objectives Lung

More information

Danish Lung Cancer Screening Trial (DLCST).

Danish Lung Cancer Screening Trial (DLCST). Danish Lung Cancer Screening Trial (DLCST). Röntgenveckan, Karlstad 11.september 2014 Jesper Holst Pedersen, MD, DMsci, Associate Professor Rigshospitalet University of Copenhagen, Denmark DLCST (Danish

More information

The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options

The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options Why We re Here The lungs What is lung cancer? How common is it? Risks & symptoms Diagnosis & treatment options What Are Lungs? What Do They Do? 1 Located in the chest Allow you to breathe Provide oxygen

More information

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group Screening for Cancer in Light of New Guidelines and Controversies Christopher Celio, MD St. Jude Heritage Medical Group Screening Tests The 2 major objectives of a good screening program are: (1) detection

More information

Survivorship Care Plans Guides for Living After Cancer Treatment

Survivorship Care Plans Guides for Living After Cancer Treatment Survivorship Care Plans Guides for Living After Cancer Treatment Institute of Medicine Report 2005 Recommendations for meeting needs of cancer survivors Implement survivorship care plan Build bridges

More information

Understanding. Lung. A guide for the patient LungCancerAlliance.org

Understanding. Lung. A guide for the patient LungCancerAlliance.org Understanding Lung nodules A guide for the patient 1-800-298-2436 LungCancerAlliance.org What is a nodule? All lung cancer initially appears as a nodule but 95% of lung nodules are not cancer. Lung nodules

More information

Patient Information Sheet Safety Aspects of CT scans

Patient Information Sheet Safety Aspects of CT scans Patient Information Sheet Safety Aspects of CT scans Radiation exposure in CT examinations What are X rays and what do they do Measuring radiation dose Naturally occurring background radiation exposure

More information

The evolution of lung cancer screening with low dose computed tomography. Heidi Roberts, Ravi Menezes

The evolution of lung cancer screening with low dose computed tomography. Heidi Roberts, Ravi Menezes The evolution of lung cancer screening with low dose computed tomography Heidi Roberts, Ravi Menezes Joint Department of Medical Imaging, UHN/MSH/WCH Toronto, ON Background and introduction Following promising

More information

Lung cancer forms in tissues of the lung, usually in the cells lining air passages.

Lung cancer forms in tissues of the lung, usually in the cells lining air passages. Scan for mobile link. Lung Cancer Lung cancer usually forms in the tissue cells lining the air passages within the lungs. The two main types are small-cell lung cancer (usually found in cigarette smokers)

More information

Lung Cancer Screening

Lung Cancer Screening NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Lung Cancer Screening Version 1.2012 NCCN.org Continue Version 1.2012, 10/26/11 National Comprehensive Cancer Network, Inc. 2011, All rights

More information

The Triad Breast Cancer Screening. Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016

The Triad Breast Cancer Screening. Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016 The Triad Breast Cancer Screening Mary Helen Hackney, MD FACP VCU Massey Cancer Center March 2016 I have no financial disclosures I am a medical oncologist with a practice focused on breast cancer The

More information

The PLCO Trial Not a comparison of Screening vs no Screening

The PLCO Trial Not a comparison of Screening vs no Screening PSA Screening: Science, Politics and Uncertainty David F. Penson, MD, MPH Hamilton and Howd Chair of Urologic Oncology Professor and Chair, Department of Urologic Surgery Director, Center for Surgical

More information

Non-Small Cell Lung Cancer Therapies

Non-Small Cell Lung Cancer Therapies Non-Small Cell Lung Cancer Therapies Guest Expert: Roy, MD, PhD Assistant Professor of Therapeutic Radiology Scott, MD Assistant Professor of Medical Oncology www.wnpr.org www.yalecancercenter.org Welcome

More information

Cancer Screening and Early Detection Guidelines

Cancer Screening and Early Detection Guidelines Cancer Screening and Early Detection Guidelines Guillermo Tortolero Luna, MD, PhD Director Cancer Control and Population Sciences Program University of Puerto Rico Comprehensive Cancer Center ASPPR Clinical

More information

Fact Sheet: Molecular Imaging and Cancer

Fact Sheet: Molecular Imaging and Cancer Fact Sheet: Molecular Imaging and Cancer Cancer causes one in every four deaths in the United States, second only to heart disease. According to the American Cancer Society, an estimated 1.48 million new

More information

Lung Cancer & Mesothelioma 2011-2015

Lung Cancer & Mesothelioma 2011-2015 Lung Cancer & Mesothelioma 2011-2015 Annex G Mesothelioma 1. The vision for mesothelioma services is set out in the Mesothelioma Framework issued by DH on 26 February 2007 (supported by the British Thoracic

More information

UNDERSTANDING SERIES LUNG NODULES. 1-800-298-2436 LungCancerAlliance.org

UNDERSTANDING SERIES LUNG NODULES. 1-800-298-2436 LungCancerAlliance.org UNDERSTANDING SERIES LUNG NODULES 1-800-298-2436 LungCancerAlliance.org CONTENTS What is a Nodule?...2 Finding Nodules...3 If a Nodule is Found... 4 What Happens Next?...6 Questions to Ask about Your Results...7

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Second primary malignancy: Focus on Hodgkin lymphoma. Matt Matasar, MD, MS Lymphoma Service, MSKCC

Second primary malignancy: Focus on Hodgkin lymphoma. Matt Matasar, MD, MS Lymphoma Service, MSKCC Second primary malignancy: Focus on Hodgkin lymphoma Matt Matasar, MD, MS Lymphoma Service, MSKCC Roadmap: Second primary malignancy Principle of oncogenicity Scope of the problem (across tumor and treatment

More information

Lung Cancer Center: How to Achieve JCI

Lung Cancer Center: How to Achieve JCI 07/30/55 1 Lung Cancer Center: How to Achieve JCI Prof. Emeritus Sawang Saenghirunvattana M.D Copyright 2012 07/30/55 2 Technology TECHNOLOGY ROADMAP Emphasis valve EBUS GS AUTOFLUORESCENSE Virtual Bronchoscopy

More information

ONLINE CONTINUING EDUCATION ACTIVITY

ONLINE CONTINUING EDUCATION ACTIVITY ARTICLE TITLE: American Cancer Society Lung Cancer Screening Guidelines ONLINE CONTINUING EDUCATION ACTIVITY Take free quizzes online at acsjournals.com/ce CONTINUING MEDICAL EDUCATION ACCREDITATION AND

More information

PSA Screening and the USPSTF Understanding the Controversy

PSA Screening and the USPSTF Understanding the Controversy PSA Screening and the USPSTF Understanding the Controversy Peter C. Albertsen Division of Urology University of Connecticut Farmington, CT, USA USPSTF Final Report 1 Four Key Questions 1. Does PSA based

More information

Test Request Tip Sheet

Test Request Tip Sheet With/Without Contrast CT, MRI Studies should NOT be ordered simultaneously as dual studies (i.e., with and without contrast). Radiation exposure is doubled and both views are rarely necessary. The study

More information

Cancer Screening Disclosures

Cancer Screening Disclosures Cancer Screening 2015 New Recommendations, New Controversies Judith M.E. Walsh, MD, MPH Division of General Internal Medicine Women s Health Center of Excellence University of California, San Francisco

More information

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening. CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests

More information

LUNG CANCER SCREENING: UNDERSTANDING LUNG NODULES. 1-800-298-2436 LungCancerAlliance.org

LUNG CANCER SCREENING: UNDERSTANDING LUNG NODULES. 1-800-298-2436 LungCancerAlliance.org LUNG CANCER SCREENING: UNDERSTANDING LUNG NODULES 1-800-298-2436 LungCancerAlliance.org 1 1 CONTENTS What is a Nodule?...3 Finding Nodules...4 If a Nodule Is Found...5 What Happens Next?...7 Questions

More information

The Need for Accurate Lung Cancer Staging

The Need for Accurate Lung Cancer Staging The Need for Accurate Lung Cancer Staging Peter Baik, DO Thoracic Surgery Cancer Treatment Centers of America Oklahoma Osteopathic Association 115th Annual Convention Financial Disclosures: None 2 Objectives

More information

Lung Cancer Screening

Lung Cancer Screening NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Lung Cancer Screening Version 2.2014 NCCN.org NCCN Guidelines for Patients available at www.nccn.org/patients Continue Version 2.2014, 04/14/14

More information

Imaging of Pulmonary Nodules. Bradley R. Trotter, MD, DABR, DABNM Department of Radiology

Imaging of Pulmonary Nodules. Bradley R. Trotter, MD, DABR, DABNM Department of Radiology Imaging of Pulmonary Nodules Bradley R. Trotter, MD, DABR, DABNM Department of Radiology brtrotter@sw.org Imaging of Pulmonary Nodules: Objectives Review imaging modalities and their use Describe imaging

More information

Detailed Order Request Checklists for Chest (Thoracic) Exams

Detailed Order Request Checklists for Chest (Thoracic) Exams Next Generation Solutions Detailed Order Request Checklists for Chest (Thoracic) Exams 8600 West Bryn Mawr Avenue South Tower Suite 800 Chicago, IL 60631 www.aimspecialtyhealth.com Appropriate.Safe.Affordable

More information

Screening of asymptomatic women using Mammograms Bayes Law and a cost/benefit analysis

Screening of asymptomatic women using Mammograms Bayes Law and a cost/benefit analysis Screening of asymptomatic women using Mammograms Bayes Law and a cost/benefit analysis There are many misconceptions about the usefulness of mammograms, as well as a considerable amount of misleading information

More information

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

More information

PET SCAN PRIMER. A Guide to the Implementation of Positron Emission Tomography Imaging in Ontario. Executive Summary

PET SCAN PRIMER. A Guide to the Implementation of Positron Emission Tomography Imaging in Ontario. Executive Summary Brought to you in partnership with: PET SCAN PRIMER A Guide to the Implementation of Positron Emission Tomography Imaging in Ontario Executive Summary Prepared by the Members of the Ontario PET Steering

More information

Prostate Cancer Screening 18 th February 2016

Prostate Cancer Screening 18 th February 2016 Prostate Cancer Screening 18 th February 2016 Mira Keyes MD FRCPC Clinical Professor Radiation Oncology Department of Surgery UBC Head, BCCA prostate Brachytherapy Program Vancouver Cancer Centre, BC cancer

More information

Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer

Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Results of Surgery in a New Lung Institute in South Texas Focused on the Treatment of Lung Cancer Lung cancer accounts for 13% of all cancer diagnoses and is the leading cause of cancer death in both males

More information

Lung Cancer Screening: An Update for the U.S. Preventive Services Task Force

Lung Cancer Screening: An Update for the U.S. Preventive Services Task Force This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ

More information

PET Scanning and Lung Cancer- A Surgeon s Perspective

PET Scanning and Lung Cancer- A Surgeon s Perspective PET Scanning and Lung Cancer- A Surgeon s Perspective Disclaimer Member of advisory board Pfizer Changing Environment Incidence Biology Detection Technology/treatment options Canadian Cancer Statistics

More information

What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide

What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide A M E R I C A N C O L L E G E O F C H E S T P H Y S I C I A N S Lung cancer is one of the most common cancers. About 170,000

More information

Patient sample criteria for the OPEIR Measures Group are all patients regardless of age, that have a specific CT procedure performed:

Patient sample criteria for the OPEIR Measures Group are all patients regardless of age, that have a specific CT procedure performed: OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES GROUP OVERVIEW 2016 PQRS OPTIONS F MEASURES GROUPS: 2016 PQRS MEASURES IN OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES

More information

MEDICAL BREAKTHROUGHS RESEARCH SUMMARY

MEDICAL BREAKTHROUGHS RESEARCH SUMMARY TOPIC: Using Video to Kill Lung Cancer REPORT: MB #4111 MEDICAL BREAKTHROUGHS RESEARCH SUMMARY BACKGROUND: Lung cancer is the second most common cancer in both men and women, excluding skin cancer. About

More information

OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES GROUP OVERVIEW 2015 PQRS OPTIONS FOR MEASURES GROUPS:

OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES GROUP OVERVIEW 2015 PQRS OPTIONS FOR MEASURES GROUPS: OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES GROUP OVERVIEW 2015 PQRS OPTIONS F MEASURES GROUPS: 2015 PQRS MEASURES IN OPTIMIZING PATIENT EXPOSURE TO IONIZING RADIATION (OPEIR) MEASURES

More information

BREAST CANCER SCREENING GUIDELINES

BREAST CANCER SCREENING GUIDELINES Chris I Flowers MBBS Associate Professor Department of Radiology and Biomedical imaging University of California, San Francisco chris.flowers@radiology.ucsf.edu BREAST CANCER SCREENING GUIDELINES Introduction

More information

Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies

Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies Breast Cancer Screening in Low- and Middle-Income Countries A Framework To Choose Screening Strategies Richard Wender, MD Session code: www.worldcancercongress.org A Five Step Framework to Guide Screening

More information

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer

L Lang-Lazdunski, A Bille, S Marshall, R Lal, D Landau, J Spicer Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine and systemic chemotherapy in malignant pleural mesothelioma. A 10-year experience. L Lang-Lazdunski, A Bille, S Marshall, R Lal,

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Breast cancer Faculty of Clinical Radiology www.rcr.ac.uk Contents Breast cancer 2 Clinical background 2 Who

More information

Spinal Tumor. North American Spine Society Public Education Series

Spinal Tumor. North American Spine Society Public Education Series Spinal Tumor North American Spine Society Public Education Series What Are Spinal Tumors? Spine tumors may arise from any of the structures of the spine or the spinal column. They may arise in the cervical

More information

PET/CT Imaging in Lung Cancer

PET/CT Imaging in Lung Cancer PET/CT Imaging in Lung Cancer Mylene T. Truong, MD Mylene T. Truong M.D. Objectives To discuss the role of PET/CT in the staging of lung cancer To review the recommendations from American Society of Clinical

More information

Radiology Workload and Follow-up Considerations

Radiology Workload and Follow-up Considerations Radiology Workload and Follow-up Considerations William C. Black, MD Department of Radiology Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center william.c.black@hitchcock.org No financial disclosures

More information

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background

Objectives. Mylene T. Truong, MD. Malignant Pleural Mesothelioma Background Imaging of Pleural Tumors Mylene T. Truong, MD Imaging of Pleural Tumours Mylene T. Truong, M. D. University of Texas M.D. Anderson Cancer Center, Houston, TX Objectives To review tumors involving the

More information

Cancer in Primary Care: Prostate Cancer Screening. How and How often? Should we and in which patients?

Cancer in Primary Care: Prostate Cancer Screening. How and How often? Should we and in which patients? Cancer in Primary Care: Prostate Cancer Screening How and How often? Should we and in which patients? PLCO trial (Prostate, Lung, Colorectal and Ovarian) Results In the screening group, rates of compliance

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: digital_breast_tomosynthesis 3/2011 6/2015 6/2016 12/2015 Description of Procedure or Service Conventional

More information

Prostate Cancer Screening

Prostate Cancer Screening Prostate Cancer Screening Bruce L. Houghton, MD Associate Professor of Medicine Division of General Medicine Department of Internal Medicine Creighton University School of Medicine http://en.wikipedia.org/wiki/image:prostatelead.jpg

More information

Lung Cancer Imaging. Carola Behrens, Diagnostic Radiology PGY-5

Lung Cancer Imaging. Carola Behrens, Diagnostic Radiology PGY-5 Lung Cancer Imaging Carola Behrens, Diagnostic Radiology PGY-5 Sharon Gershony, Diagnostic Radiology/Nuclear Medicine PGY-5 Maura Brown, FRCPC Diagnostic Radiology None Disclosures Objectives To review

More information

Disclosures. Definitions. CDC Website

Disclosures. Definitions. CDC Website Disclosures Deborah Grady, MD, MPH Professor of Medicine Deputy Editor, JAMA Internal Medicine Co-Director, Center for Healthcare Value Co-Director, Clinical and Translational Science Institute Salary

More information

A Checklist for Patients with Breast Cancer

A Checklist for Patients with Breast Cancer A Checklist for Patients with Breast Cancer Questions to Ask the Doctor 1 and Quick Help Resources 1 Adapted from: American Cancer Society. Detailed Guide: Breast Cancer - What Should You Ask Your Doctor

More information

Providing Guidance on Lung Cancer Screening to Patients and Physicians

Providing Guidance on Lung Cancer Screening to Patients and Physicians Providing Guidance on Lung Cancer Screening to Patients and Physicians An Update from the American Lung Association Lung Cancer Screening Committee April 30, 2015 Executive Summary Lung cancer kills more

More information

OBJECTIVES By the end of this segment, the community participant will be able to:

OBJECTIVES By the end of this segment, the community participant will be able to: Cancer 101: Cancer Diagnosis and Staging Linda U. Krebs, RN, PhD, AOCN, FAAN OCEAN Native Navigators and the Cancer Continuum (NNACC) (NCMHD R24MD002811) Cancer 101: Diagnosis & Staging (Watanabe-Galloway

More information

Monitoring Clinical Stage to Improve Care

Monitoring Clinical Stage to Improve Care Monitoring Clinical Stage to Improve Care Stephen Dreyer, MD, FACS Cancer Liaison State Chair Nebraska Fremont, NE M. Asa Carter, CTR Manager, Accreditation and Standards American College of Surgeons Chicago,

More information

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals

Chirurgie des métastases cérébrales. Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals Chirurgie des métastases cérébrales Dr Mark Dexter Head, Department of Neurosurgery The Westmead Hospitals The Westmead patient population THE INCONVENIENT TRUTHS Cerebral metastases occur in 10 16 % of

More information

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Case #1 A 55 yo white man with well-controlled hypertension presents for his annual

More information

There must be an appropriate administrative structure for each residency program.

There must be an appropriate administrative structure for each residency program. Specific Standards of Accreditation for Residency Programs in Radiation Oncology 2015 VERSION 3.0 INTRODUCTION The purpose of this document is to provide program directors and surveyors with an interpretation

More information

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND

Surgeons Role in Symptom Management. A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Surgeons Role in Symptom Management A/Prof Cliff K. C. Choong Consultant Thoracic Surgeon Latrobe Regional Hospital GIPPSLAND Conditions PLEURAL Pleural effusion Pneumothorax ENDOBRONCHIAL Haemoptysis

More information

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma

Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Rotation Specific Goals & Objectives: University Health Network-Princess Margaret Hospital/ Sunnybrook Breast/Melanoma Medical Expert: Breast Rotation Specific Competencies/Objectives 1.0 Medical History

More information

Information for. Patients with an Abnormal Lung X-Ray

Information for. Patients with an Abnormal Lung X-Ray Information for Patients with an Abnormal Lung X-Ray Some of the materials in this resource were adapted, with permission, from: Understanding Lung Cancer, Juravinski Cancer Centre, Hamilton Health Sciences,

More information

Primary -Benign - Malignant Secondary

Primary -Benign - Malignant Secondary TUMOURS OF THE LUNG Primary -Benign - Malignant Secondary The incidence of lung cancer has been increasing almost logarithmically and is now reaching epidemic levels. The overall cure rate is very low

More information

Lung cancer. A guide for journalists on Non-Small Cell Lung Cancer (NSCLC) and its treatment

Lung cancer. A guide for journalists on Non-Small Cell Lung Cancer (NSCLC) and its treatment Lung cancer A guide for journalists on Non-Small Cell Lung Cancer (NSCLC) and its treatment Contents Contents 2 3 Section 1: Lung Cancer 4 i. Types of lung cancer 4 ii. Causes and risk factors 5 iii. Symptoms

More information

Breast Cancer Screening Guideline July 1, 2010

Breast Cancer Screening Guideline July 1, 2010 Breast Cancer Screening Guideline July 1, 2010 Introduction These guidelines are informational only and are not intended or designed to substitute the reasonable exercise of independent clinical judgment

More information

The Evaluation of Cancer Control Interventions in Lung Cancer Using a Canadian Cancer Risk Management Model

The Evaluation of Cancer Control Interventions in Lung Cancer Using a Canadian Cancer Risk Management Model The Evaluation of Cancer Control Interventions in Lung Cancer Using a Canadian Cancer Risk Management Model WK Evans, M Wolfson, WM Flanagan, J Shin, FF Liu JR Goffin, K Asakawa, N Mittmann, L Fairclough

More information

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj. PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening

More information

Ellis Fischel Cancer Center Registry Data Public Reporting of Outcomes: Breast Cancer

Ellis Fischel Cancer Center Registry Data Public Reporting of Outcomes: Breast Cancer Ellis Fischel Cancer Center Registry Data 13 Public Reporting of Outcomes: Breast Cancer To satisfy Standard 1.12 of the American College of Surgeons Commission on Cancer, a review of outcomes related

More information