DCI Providers Address Reports, Trends, in Lung Cancer Screening, Survival

Lung scans
David Gira with Dr. Crawford holding a large wooden white ribbon for lung cancer awareness
Lung cancer survivor David Gira & his oncologist Jeffrey Crawford, MD. The photo was taken in Nov. 2020. As of this Nov. 2020, Gira remains a survivor.
A new report by the American Lung Association — 2022 State of Lung Cancer report — found an increase in the five-year lung cancer survival rate from 21% in 2014 to 25% in 2018.

However, lung cancer remains the leading cause of cancer death in the U.S. The report also revealed that:

Two DCI providers were interviewed by media this month (November), Lung Cancer Awareness Month, to address trends in lung cancer screening, treatments, and disease survival.

Jeffrey Crawford, MD, DCI thoracic medical oncologist and professor, told CNN: “A 21% increase in five-year survival is good. I don’t think there are too many other groups that have seen that level of improvement...It’s disappointing that the advances we are seeing are not due to massive success screening for lung cancer, which we should be doing. We’re still only screening a minority of patients ... We’ve failed to get the primary care docs to change their attitudes about lung cancer because for decades, I think there’s been a kind of pessimism about lung cancer. They say it’s a smoker’s disease, and the outcomes are poor, or they think patients won’t be healthy enough to get surgery, so there’s no need to screen. There’s all sorts of misconceptions that just really aren’t true anymore, but I don’t think we’ve really gotten that message through as opposed to mammography for breast cancer. No one’s going to argue about that."

Betty Tong in a flowered surgical cap performing surgery

Betty Tong, MD, MHS, MS, (left) DCI thoracic surgical oncologist and associate professor, told CBS-17: “It’s important to remember that about one out of five cases of lung cancer happen to people who don’t smoke cigarettes and don’t have a history of cigarette smoking exposure. That being said, people with a history of smoking cigarettes are most at risk for lung cancer and we have a screening method for people who do have a history of smoking cigarettes.”

The U.S. Preventive Services Task Force currently recommends annual lung cancer screening for adults between the ages of 50 and 80 who are either current smokers or quit within the past 15 years AND who have a 20 “pack-year” or greater smoking history; that’s at minimum one pack-a-day for 20 years or two packs-a-day for 10 years. Tong says that to qualify for lung cancer screening at Duke, these criteria must be met. Patients must also be asymptomatic and well enough to undergo potential treatment for lung cancer. 

Unlike mammography or colon cancer screening, lung cancer screening requires a shared decision-making visit in advance. Prior to the scan, an advanced practice provider speaks to the patient about the risks and benefits of screening and is also available to discuss tobacco cessation options at Duke.

Should patients discover they do have lung cancer, Tong says, they will find themselves in good hands at DCI.

“From the surgical side, Duke is a pioneer in minimally invasive surgery for lung cancer, which gets people back and recovered much faster with less pain and better quality of life than traditional surgery,” Tong assures. “In addition, there are a range of therapies newly available to treat more advanced lung cancers.”

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