"The first year of free lung cancer screening in the Augusta Georgia area found more than double the rate seen in a previous large national study as well as a Massachusettsbased screening for this number one cancer killer.  The higher rates coupled with the majority of cases being found in early treatable stages point toward the need for ongoing accessible free screening in highrisk populations and underserved regions say researchers at the Georgia Cancer Center at Augusta University. High risk includes those who have smoked a pack of cigarettes daily for two or three decades and if theyve quit smoking did so less than  years ago.  The screening of  highrisk individuals within a mile radius of Augusta found  percent had lung cancer and  percent of those were caught early said Dr. Carsten Schroeder thoracic oncology surgeon at the Georgia Cancer Center and Medical College of Georgia at AU. The researchers note that a percentage of the patients presenting at screening had early symptoms like a persistent cough so the rate of cancer detection in patients who showed no indication of disease was . percent still double the rates of previous studies.  Lung cancer is still the number one cancer killer in the United States and in our world Schroeder said. If we catch it in the early stages ideally before symptoms surface we can operate and patients can have an overall survival rate of  percent. Fiveyear survival rates are closer to  percent in more advanced disease.  The pioneering National Lung Screening Trial which began in  and included  largely urban centers found  cases of lung cancer among the  highrisk individuals screened in the first year for a rate of . percent. That study also provided the first broad evidence that lowdose computed tomography or LDCT was a more effective screening tool than the traditional chest Xray. A decade later the Massachusettsbased Lahey Hospital  Medical Center on which the Augusta screening was modeled found a . percent prevalence in the first  months of screening. Like the previous experiences the Augusta area screening that started in  also reiterated the ability of LDCT to find lung cancer early said Schroeder corresponding author of the study in Southern Medical Journal.  Six of the eight cases found in the screening were considered potentially curable with surgery. Positive results were communicated directly to the participants primary care provider negative results were communicated to primary care docs and participants along with a reminder for another screening in a year.  Participants particularly from surrounding more rural communities have limited access to health care Schroeder said. The areas median household income is  percent lower than the national average and the poverty level is  percent higher according to the U.S. Census Bureau. The Augustaarea experience found generally younger patients who started smoking earlier in life and had multiple risk factors. Augusta area participants were an average of  years old about half male and female more than  percent were white and nearly  percent were black.  It doesnt matter how old you are if you have smoked  years you might want to consider a lungcancer screening Schroeder said referencing the reality that some adults started smoking as children. Part of his drive to start a screening program in the Augusta area was that when he relocated here three years ago from the Cleveland area he found patients were often referred to him with later lesstreatable disease. In the Cleveland area where Schroeder previously practiced as a faculty member at Case Western Reserve University and where access to health care andor health insurance was more widely available early lung cancers might even be detected incidentally when patients had CT scans for a variety of other reasons. Augusta researchers were able to offer free screening by utilizing natural downtime of the combined positive emission tomography or PET and computed tomography or CT scanner said Dr. Norman B. Thomson III chief of generalcardiothoracic radiology in the MCG Department of Radiology and Imaging and study coauthor. The combination technology is often used to visualize other tumor types throughout the body and many patients require an injection of sugar dye which will be taken up by the tumor but must first circulate for about an hour before the scan is done. That means the machine is staffed at times when it is not able to be fully used for other diagnostic procedures time that provides a natural window for lung screening using just the CT imaging capability in under five minutes from arrival to exit Thomson said. More typically a scan could cost between .  In the last decade CT technology has gotten increasingly adept at picking up early small nodules Thomson said. Low radiation doses work well in the lungs which are mostly filled with air that provides a blank background for nodule surveillance. Thomson notes that means LDCT is also adept at finding things like scar tissue and small inflammatory nodules that also are more common in the lungs of smokers. Nodules a third of an inch or smaller tend not to be cancer and more solid masses tend to be Thomson said. They may follow up on smaller nodules in six months then if the nodule is stable go back to annual reviews. And while some lung cancers are super aggressive screening also may uncover some slowgrowing versions that  like some prostate cancers  will not threaten life but need to be treated andor closely followed once found. Thats why the acid test for screening is not how many cancers you find or what stage the cancer is Thomson said rather what screening does to lung cancer death rates. Current evidence definitely supports screening he said. Also like lung cancer has been coincidently found in CT scans for other reasons physicians like Thomson and Schroeder are now incidentally finding cardiovascular disease in their lung cancer screening.  To date about  individuals have been screened in the Augusta area and Schroeder is working to expand statewide hoping to use the state public medical schools extensive campus network that has students learning from physicians at practices and hospitals across Georgia as a natural base.  We want to reach as many people as we can as early as we can he said. Also about half of patients screened continue to smoke so screening might also be a logical point for smoking intervention Schroeder said.  The original National Lung Screening Trial orchestrated by the National Cancer Institute and the American College of Radiology was launched in  and enrolled nearly  patients nationally. Fiveyear survival rates were about  percent for early cancers and about  percent for lung cancer found late.  Following the trial the National Comprehensive Cancer Network a nonprofit organization of cancer centers that develop guidelines for cancer diagnosis and treatment along with the United States Preventive Services Task Force which makes recommendations for preventive medicine recommended screening highrisk individuals on a slightly broader scale which the Lahey and Augusta area screening used. The group recommends screening for those age  with a pack year or greater history who have stopped smoking for  years or less and those age  or older with a pack year smoking history and an additional risk factor other than secondhand smoke such as family history of lung cancer or a personal cancer history. A pack year means smoking one pack a day for  years or a variation like two packs daily for  years. After  years of not smoking the lung cancer risk tends to diminish but never vanishes. Schroeder would prefer the screening still not stop there.  A total of  individuals signed up for the Augusta area screening  qualified and  actually had LDCT. More than  patients were not screened in the first year primarily because of socioeconomic and travel limitations that created a sixweek backlog. Ninety percent of lung cancer is related to cigarette smoking the leading cause of preventable disease and death in the United States according to the Centers for Disease Control and Prevention. Symptoms of lung cancer include persistent intense coughing shortness of breath pain in the chest shoulder or back and changes in the color andor volume of phlegm or mucus hoarseness and coughing up blood.  A  survey of smoking by adults by the Centers for Disease Control and Prevention found about  percent of adults in the country smoked rates for Georgia and adjacent South Carolina were between  percent. Rates in Massachusetts where the Lahey screening occurred are . to . percent. Rates were highest in certain demographics. As examples smoking rates were highest among those without a graduate education degree certificate and lowest among those with a graduate degree higher among those living below the poverty level versus above it and higher among some minorities such as American Indians and Alaska Natives multiple race individuals and blacks.  For more information about free lung cancer screening at the Georgia Cancer Center and MCG call  or email lungaugusta.edu mailtolungaugusta.edu."