Lung screening in BC is organized under a partnership framework with regional health authorities, hospital screening sites, primary care providers, and specialists. With 70 per cent of all cases diagnosed at an advanced stage, the Lung Screening Program aims to detect lung cancer at an earlier stage, when treatment is more effective. A network of lung screening clinics has been established across BC within each health authority, using the existing computed tomography (CT) capacity in hospitals for patients to access.
Lung screening involves a low-dose computed tomography (LDCT) scan of the lungs. During the scan, the patient lies on a table, and a CT scanner takes detailed images of their lungs. The scan takes less than 15 seconds and is not painful. Patients do not need to take any medications, or receive any needles for this test. After a patient's LDCT scan, a radiologist with expertise in early diagnosis will review the images taken at a designated reading site located within the patient's health authority. Results of the patient's lung scan will be sent to the patient and their primary care provider.
An organized lung screening program is essential for the following reasons:
- To ensure eligible British Columbians have an equitable opportunity to participate in high quality lung screening;
- To ease the burden on primary care providers by acting as a centralized resource and assuming responsibility for eligibility determination, shared decision making, smoking cessation counselling, results communication, early recall notification and future surveillance reminders until upper age limit is reached, or the individuals are no longer eligible for screening due to co-morbidities;
- To provide standardized communication, screening and care to individuals at high-risk for lung cancer; and,
- If screening results are abnormal, to provide individuals with the appropriate recommendation for further testing and follow-up.
Should my patient get a low-dose CT (LDCT) scan?
Generally, anyone between the ages of 55 to 74, who are considered high-risk and do not have any symptoms, may be eligible for screening.
Routine screening is
not recommended.
Never smoked in the past.
- Routine screening is not recommended.
Never smoked in the past.
- Routine screening is
not recommended.
Has a significant history of regularly smoking commercial tobacco (cigarettes, cigars, etc), currently or in the past.
- Patient is encouraged to call 1-877-717-5864 directly to complete a consultation and risk assessment over the phone to confirm their screening eligibility.
- For patients who you consider may experience barriers to self-referral (e.g., language barrier, screening hesitancy), complete and fax the Risk Assessment Request Form to 1-604-877-6115. A Program Navigator will contact the patient by phone to determine screening eligibility.
- If your patient cannot be contacted by phone or would need support answering the risk assessment questions, you could complete the assessment together with the patient and fax the responses to the Lung Screening Program. The Lung Screening Program will review your assessment and facilitate referral for screening if the patient is eligible. Email lungscreeningprogram@bccancer.bc.ca to request a copy of the questionnaire.
- If the patient is considered eligible, routine screening is recommended annually or biennially.
Do not screen. Refer for diagnostic testing.
Symptomatic, includes:
- Coughing that does not go away or gets worse
- Coughing up blood or rust-coloured sputum (spit or phlegm)
- Shortness of breath or chest pain that is always felt and gets worse with deep breathing or coughing
- Unexplained weight loss of more than 5 kilograms in the past year
Re-screen in 2 years. The radiologist did not notice anything of concern from the patient’s LDCT scan.
The patient will receive a reminder letter in the mail. You will receive a report when the LDCT scan has been completed. You will also receive a reminder if the patient has not scheduled their next screen after 4 weeks.
Re-screen in 1 year. The radiologist considers the patient to have a low chance of lung cancer but recommends continued monitoring of their lungs.
The patient will receive a reminder letter in the mail. You will receive a report when the LDCT scan has been completed. You will also receive a reminder if the patient has not scheduled their next screen after 4 weeks.
Follow-up LDCT scan in 3 months. The radiologist has noticed some findings in the patient’s LDCT scan that may be related to inflammation, infection or a need to monitor an area more closely.
The patient will be contacted to arrange a follow-up LDCT scan in 3 months. You will also be notified of the result.
The radiologist has noticed some spots that require further investigation. The program will send a fast-track diagnostic work-up referral to a designated thoracic centre in the patient’s health region.
The patient will be contacted shortly by a chest specialist to arrange for a follow-up, which may include more scans or a biopsy. You will also be notified of the result.
The radiologist has noticed additional actionable findings that are not related to cancer.
