Routine mammograms could bridge critical gap in lung cancer screenings, study finds

At the moment, a routine mammogram might soon offer a vital opportunity to screen for another deadly disease. According to a study, more than a third of women eligible for life-saving lung cancer screenings are missed because standard medical records fail to capture accurate smoking stories. For more insight on this, let's welcome Dr. Jeff Velotta, a thoracic surgeon and member of the American Cancer Society. Dr. Velotta, thank you so much for joining us this morning. Thank you. Yes. You brought this in as well with you to hold up as we do this interview. Tell us why. Yeah, the White Ribbon Project, because right as we head to Lung Cancer Awareness Month in November, we're talking about breast cancer as well. This is the signature that says, hey, white pearls. We're going to talk about pink with breast. It's all coincided. They're all similar risk factors. So this represents lung cancer. Represents lung cancer. You know, millions of women, they never miss their mammogram screenings. Yet a study shows that many of them at high risk are completely missing out on lung scans. How are they slipping through the cracks? Why is this happening? Yeah, you put it perfectly in the intro. It's that the smoking history. Breast cancer screening is recommended if you're 40 and a woman. But regardless, just 40 and a woman. That's really easy and simple. Lung cancer screening, 50 and above, so a little bit higher. But you have to have a smoking history, 20 pack years or current smoker or quit within 15 years. So what we're missing is, is these women definitely could qualify, but the smoking history is not always in the chart where we're used to seeing it because we don't, doctors don't always have time to fill in when the smoking histories are, what the exact smoking history is of how many packs per year. So it's based on what the doctor fills in on their chart and that is what precedes a lung cancer scan recommendation. Right. It's all about smoking history and age. Okay. So does that need to change is what you're saying? What needs to happen? Well, what needs to happen is, I mean, we're not going to necessarily change the guidelines for lung cancer screening. It's still going to require a smoking history as of now. But really what needs to change is we need to take a more active measure to just ask more often our patients, whether a doctor, a medical assistant, just any family members, and have even patients out there to say, this is my smoking history, this is what I did, or this is what I did smoke in the past. And if you put that, enter that in there, then the doctor will know or the primary care provider will know that you qualify for lung cancer screening. So the question I guess I have is, is that missed opportunity? Because we know that certain people, you know, must get that lung cancer screening, certain women. But is that missed opportunity from the doctor's point of view or from the patient's point of view? You know, it's actually, it's a little bit of both. But we're not blaming anybody. Right. Not to blame, but I want to get drilled down to it so we figure out a way to fix it. Right. And so what we did in this, in this study to fix it really is that you just said it perfectly. The women, we know that women have been doing mammograms since the 1970s, even earlier from trials. So it's a well-known fact that mammograms save lives. And we know about 80 to 90% of our women in California actually go to get their mammogram. It's awesome. So why not go? They're already coming in for a routine mammogram. Why not ask them? So what we did is just ask them two questions. What's your smoking history? And if you did smoke, how many packs a day if you did? And if you qualified, we can go ahead and then sign them up for lung cancer screening. Just right then and there. Correct. To get it out of the way, you screened a group of these overlooked women with low-dose CT, and every single one of them had lung nodules. How closely do these patients come to being diagnosed too late? Well, no, the ones from the screening, we caught them early. Yeah, you caught them early, right. But it's when they don't get screened. Right. That's what we see. That's when we don't see it. That's what it gets down to. Yeah, when you don't catch them on screen. All right, so doctors rely on electronic health records every day, but your study reveals the standard social history tab missed over 90 percent of smoking details uh why is medical software um you know failing to flag these patients or is it the software well what are your thoughts that's the thing we don't have a software for it right now this is just entering manual entering into social history by whether a medical system but AI or something automated that's the future and a lot of groups are doing that um and a lot of hospital systems hope to be doing that too because if we could just and you know enter that in through a computer system it be so much easier yeah it would be much easier to catch you said 90% of women in California get the mammogram what's the percentage do we know that get the lung cancer screening we do yes we do uh in the national average 18 percent wow eligible what in California it's even lower so we have a lot of work to do that's why i'm excited to hopefully get people in yeah screening um they you know breast cancer survivors i found interesting face a higher risk of developing lung cancer later in life. So is that a way of really pairing those two together to get both of those scans at the same time? Yes. Another avenue to make sure you bookend both sides of making sure someone gets scanned? Absolutely. They come hand in hand. Just regardless of smoking, just a personal history of breast cancer increases your risk of developing lung cancer. Just the breast cancer alone. Just the breast cancer alone. And then if you add smoking and age, just getting older, it triples it. But if breast cancer alone increases it, shouldn't that already include the lung cancer screening? I mean, if you're a doctor in a perfect world, that would be great, right? Yes, Andre, you're right on. That's exactly what I want in my perfect world. But right now, the guidelines is with a smoking history. But we do know with new research that we're showing that a personal history of breast cancer increases your risk of lung cancer. I hope in the future that will change, that it doesn't have to just be smoking history. It can be personal history of breast cancer other things that increase your risk how would those guidelines go to change in the future where do we start with that so someone watching from the outside looking at the policy change so what we have to do we show the research retrospectively now we need to show in screening trials now the the government U.S. Preventive Services Task Force want to see a trial showing okay if you screen these women regardless of smoking with a personal history of breast cancer or a family history of lung cancer we've shown that before in the data we look back but Now do a real trial, screen them, and see. See what you see. See what the lung cancer detection rate is. All right. There you go. Policy changes. I just want people to know because maybe there's some way on their end they can lobby and just, you know, take some initiative to get, you know, those laws, you know, line up with what doctors are saying. It could save some lives. Absolutely. Yeah, that lung cancer screening number is very low. Yes. Very scary because it can save a lot of lives. Dr. Jeff Valota, a thoracic surgeon and a member of the American Cancer Society, thank you so much for joining us this morning. We appreciate it. Thank you, Andre. Yeah, white ribbon. Appreciate it. Thank you. Have a good one.