When high quality programs screen patients, the balance of benefit and harms tips toward lung cancer screening — cancers are detected sooner, and fewer unnecessary interventions occur.
The potential for molecular biomarkers to tip the balance from benefit to harm in lung cancer screening and nodule diagnosis and to enhance risk prediction warrants a robust discussion about how we determine their accuracy and readiness for clinical use.
Based on our experience at Cleveland Clinic, we favor centralized management of screening decisions in our health system, detailed and thorough shared decision-making visits with one-year follow up and concrete plans for managing incidental findings.
The low-dose chest CT scan used for lung cancer screening frequently demonstrates incidental findings in the anatomic structures imaged from the neck to the upper abdomen. This study describes the frequency of incidental findings and their clinical and financial downstream effects.
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A centralized counseling and shared decision-making visit prior to lung cancer screening can help patients make value-based decisions about their care and ensure a lung cancer screening program is high quality and patient centered.
Cleveland Clinic is collaborating with industry biomarker developers to improve lung cancer biomarkers on the market, as well as developing volatile organic compound biomarkers of the breath, urine and blood.
Medicare now covers annual low-dose CT screenings for patients at greatest risk of developing lung cancer. This test can reduce lung cancer deaths in high-risk patients by 20 percent.