Breath of Life: The Power of Low Dose CT Screening for Early Lung Cancer Detection

Dr. Brandon Twombly and Dr. Paras Shah, Crozer Health Family Medicine Residents

Karen Breitmayer, ChesPenn’s Director of Grants, Data, and Special Projects, is a lung cancer survivor.  Karen quit smoking years ago.  For over 12 years, she hadn’t experienced any symptoms that suggested  lung disease, so she assumed she was in the clear.  But she had a conversation with Dr. Letitia O’Kicki, ChesPenn’s Chief Medical Officer, about an initiative to increase the use of low-dose CT scanning for patients at risk of lung cancer and she realized that she was in the high risk group.  She decided to get tested and learned that she had a tumor in her lung.  Fortunately, the tumor was small and self-contained.  Her surgeon was able to remove it and she is completely cancer free.

Karen was lucky.  While lung cancer is the second most common cancer – just behind prostate cancer for men and breast cancer for women – it’s by far the most common cause of cancer death, accounting for more fatalities than colon, breast, and prostate cancer combined.  The American Cancer Society estimates that approximately 127,070 people will die of lung cancer in the United States this year.

In recent years, the low-dose CT (LDCT) scan has emerged as a powerful, cost-effective screening tool for lung cancer, offering hope that we can dramatically lower the mortality rate of this still too common cancer.

But a tool is only effective when we use it.  For years, physicians have routinely recommended mammograms and colonoscopies to screen for breast and colon cancer, dramatically lowering the mortality rate for both diseases.  However, until recently, no such screening tool has been regularly recommended for lung cancer.  According to Dr. Rachelle Lanciano, Chair of Radiation Oncology at Delaware County Memorial Hospital, only 8 – 9% of high-risk patients in Pennsylvania currently receive an LDCT scan.

ChesPenn and Crozer Health have launched an initiative to change that.  Recognizing the need for physician education, in 2023, ChesPenn’s Chief Medical Officer, Dr. Letitia O’Kicki, with Crozer Health Family Medicine Residents Dr. Brandon Twombley and Dr. Paras Shah developed a protocol that primary care providers can use to determine which patients should receive a CT scan.

Drs. Twombley and Shah shared that orders for screening increased by almost 400% in 2023 compared to 2022.  While not everyone follows up, often because of transportation barriers, the actual number has increased by 300%.  This places Crozer and ChesPenn in a leadership position in Pennsylvania for the use of this life-saving tool.

Patients recommended to receive LDCT scans are:

  • 50 years and older and
  • have quit smoking within the last 15 years and
  • smoke or smoked a pack a day for 20 years or longer.

In addition to training primary care providers at Crozer and ChesPenn to screen patients for their risk and refer them for a scan, ChesPenn has secured a grant from Ride Hard Breathe Easy, a Philadelphia-based organization that raises awareness and promotes early lung cancer screening, to cover the cost of LDCT scans for our uninsured patients.  Our hope is that with time, training, and the resources to ensure that everyone who is at risk can get this life-saving test, more people like Karen will have a full recovery and a long, healthy life.



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