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Health Matters: Providence Holy Cross Medical Center | 9 L ung cancer kills more people—men and women—than any other kind of cancer. In 2021, the American Cancer Society estimated that by the end of the year more than 235,000 would be diagnosed with lung cancer in the U.S., and more than 131,000 would die from the disease. In light of the fact that there are 34.1 million adult smokers in the country, screening is paramount. We talked with Vivian Gonzalez, Oncology Program nurse practitioner and tobacco treatment specialist (TTS), about the Providence Holy Cross lung cancer screening program. When did the medical profession become more proactive about screening for lung cancer? At Holy Cross, we have been actively screening patients since 2017. Patients are usually referred by a doctor's order or are self-referred. People can call 877-LUNG- INFO (586-4463) to see if they qualify. The move to increase screening came after a large U.S. clinical trial showed that screening with low-dose spiral computed tomography (LDCT) reduced lung cancer mortality by about 20% compared with standard chest X-ray among current or former heavy smokers (at least 30 pack years). The goal of lung cancer screening is to detect lung cancer at a very early stage—when it is more likely to be cured. By the time lung cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Based on this information, the American Cancer Society issued guidelines in 2013 recommending annual lung cancer screening for current or former heavy smokers ages 55 to 74 who are in relatively good health and have undergone smoking cessation counseling. Recently, two European trials reported even larger mortality reductions for screening among a more moderate risk pool. In July 2020, the U.S. Preventive Services Task Force issued a draft statement expanding its recommendation to adults 50 to 80 years old with a 20-pack-year smoking history. How does the screening work? When we get a referral, we contact the patient and make sure they fit the screening criteria. They have to fit the age and smoking criteria (above), have to have no symptoms such as chest pain or shortness of breath, and they can't be coughing up blood or have recent major weight loss. Once they meet the criteria, they can be screened at one of our imaging centers in Porter Ranch or Santa Clarita. We make available smoking cessation interventions such as referring to the California Smokers' Helpline (800-NO-BUTTS) and sending smoking cessation materials. What happens afterwards? Once a patient has a low- dose screening, the images created during the scan are compiled by a computer and reviewed by a doctor who specializes in imaging tests (board-certified radiologist). As with mammography screening, a patient will receive a letter with recommendations for follow-up. If an abnormality is found, the care team may recommend additional tests. Has this program shown positive results? We have been designated a Lung Cancer Screening Center of Excellence by the Lung Cancer Alliance, which shows we have performed best practices in this area. In 2017 we screened approximately 140 people, in 2020 about 400, and we anticipate screening more than 500 people in 2021. We have found several early-stage cancers. These screenings save lives, and it is really important to get the word out—through primary care physicians and directly to smokers—to make sure everyone who needs to gets screened. Catching lung cancer early and treating it quickly leads to the best hope of beating the disease. Lung Cancer Screening Program Saving lives with early detection

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