Corewell Health pulmonologists encourage early screening for lung cancer

Two Corewell Health pulmonologists discussed the importance of early lung cancer screening at a news conference Wednesday morning in honor of World No Tobacco Day.

Commercial tobacco use is the largest cause of preventable deaths in Michigan and kills more than auto accidents, overdoses, alcohol, homicides and suicides each year combined, according to the state department of health. Lung cancer was a "silent killer" for a long time, and mortality rates have only started to plateau recently due to early screening efforts, said Mohamad Raslan, a pulmonologist at Corewell Health Beaumont Hospital's Lung Nodule Clinics in Trenton and Wayne.

Patients between the ages of 50 and 80 years old who smoked one pack of cigarettes a day for 20 years or more qualify for lung cancer screening, said Abdulrazak Alchakaki, another pulmonologist at Corewell Health Beaumont Hospital's Lung Nodule Clinics in Trenton and Wayne. Patients who meet these conditions and who have quit smoking in the last 15 years also qualify.

Any doctor can refer patients who meet these criteria for screening. The next step is to obtain a computed tomography (CT) scan.

"Once they get the (CT) scan done, if it shows any findings, then it is very important for those patients to be seen in a pulmonary clinic," Alchakaki said. "I prefer those patients seeing a lung nodule clinic which is, again, a high specialty clinic, compared to a general pulmonary clinic."

Raslan likened the CT scan screening test for lung cancer to a mammogram for breast cancer or a pap smear for cervical cancer. The scans can detect lung nodules, or growths in the lung that range from a few millimeters to 1 inch in size.

Physicians at Corewell Health's lung nodule clinics determine which nodules need to be biopsied, monitored or removed. Around 90% of lung nodules are benign but the 10% that are not can be malignant, Raslan said.

"The earlier we diagnose lung cancer, the better survival is and the better prognosis is," Raslan said. "We navigate those 10% and make a priority to which one we need to act and how fast we need to act."

The clinics saw roughly 530 patients who had been screened for lung cancer and had concerning CT scans last year, Alchakaki said. Cancer was detected in around 44 of them, but roughly 70% were caught in the early stages.

"That means the cancer was resectable," Alchakaki said. "These numbers are really amazing when you compare it to national benchmarks."

Early-stage lung cancers, meaning stages one to three A, are resectable, meaning they can be removed by surgery. Resection can also be supplemented with chemotherapy or immunotherapy. Patients with non-resectable cancer will likely receive more palliative chemoradiation therapy than those in earlier stages, Alchakaki said.

Nationwide, only 20.8% of lung cancer cases underwent surgery as the first course of treatment in 2022, according to the American Lung Association. Just 5.8% of eligible Americans have been screened for lung cancer and Michigan ranked among the worst 10 states in the country in terms of early lung cancer diagnosis in 2021, the association reports.

This year Corewell Health's clinics have seen over 300 patients between January and April and detected around 29 cancer cases, Alchakaki said.

A close relationship with radiology, oncology and surgical departments is necessary for the lung nodule clinics to diagnose and act on lung cancer as early as possible, Raslan said. Nurse navigators work to educate primary care providers in the area and establish a relationship between them and the lung nodule clinics to facilitate early cancer diagnoses.

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