© 2018 Genentech USA, Inc. All rights reserved. ALE/070617/0063(1) 11/18Lung-RADS is a trademark of the American College of Radiology.

References: 1. American Cancer Society. Can non-small cell lung cancer be found early? American Cancer Society website. https://www.cancer.org/cancer/non-small-cell-lung-cancer/detection-diagnosis-staging/detection.html. Revised May 16, 2016.small-cell-lung-cancer/detection-diagnosis-staging/detection.html. Revised May 16, 2016. Accessed July 17, 2017. 2. de Koning HJ, Meza R, Plevritis SK, et al. Benefits and harms of CT lung cancer screening strategies. A comparative modeling study for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(5):311-320. 3. National Cancer Institute. SEER stat fact sheets: lung and bronchus cancer. National Cancer Institute website. https://seer.cancer.gov/statfacts/html/lungb.html. Accessed July 17, 2017. 4. Centers for Disease Control and Prevention. Lung cancer screening programs. Centers for Disease Control and Prevention website. http://wwCenters for Disease Control and Prevention website. http://www.cdc.gov/cancer/ncccp/pdf/lungcancerscreeningprograms.pdf. Accessed July 17, 2017. 5. American Cancer Society. Surgery for non-small cell lung cancer. American Cancer Society website. https://www.cancer.org/cancer/non-small-cell-lung-cancer/treating/surgery.html. Revised May 16, 2016. Accessed July 17, 2017.6. The National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. 7. Moyer VA; U.S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. 8. National Cancer Institute. Computed tomography (CT) scans and cancer. National Cancer Institute website. https://www.cancer.gov/about-cancer/diagnosis-staging/ct-scans-fact-sheet. Reviewed July 16, 2013.July 16, 2013. Accessed July 17, 2017. 9. Massachusetts General Hospital. Lung screening: FAQ for patients. Massachusetts General Hospital website. http://www.massgeneral.org/imaging/services/lung-screening-faq-patients.aspx. Accessed July 17, 2017. 10. McKee BJ, Regis SM, McKee AB, Flacke S, Wald C. Performance of ACR Lung-RADS in a clinical CT lung screening program. J Am Coll Radiol. 2015;12(3):273-276. 11. American College of Radiology. Lung CT screening reporting and data system (Lung-RADS™). American College of Radiology website. https://www.acr.org/Quality-Safety/Resources/LungRADS. Accessed July 17, 2017. Accessed July 17, 2017. 12. Pinsky PF, Gierada DS, Black W, et al. Performance of Lung-RADS in the National Lung Screening Trial: a retrospective analysis. Ann Intern Med. 2015;162(7):485-491. 13. US Preventive Services Task Force. Final recommendation statement: lung cancer: screening. US Preventive Services Task Force website. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/lung-cancer-screening. Revised December 2016. Accessed July 17, 2017. 14. Centers for Medicare & Medicaid Services. Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439N). Centers for Medicare & Medicaid Services website. https://wwtomography (LDCT) (CAG-00439N). Centers for Medicare & Medicaid Services website. https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274. Accessed July 17, 2017. 15. National Cancer Institute. NCI dictionary of cancer terms. National Cancer Institute website. https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=46171. Accessed July 17, 2017. 16. U.S. Centers for Medicare & Medicaid Services. Your Medicare coverage: lung cancer screening. Medicare website. https://www.medicare.gov/coverage/lung-cancer-screening.html. Accessed September 28, 2018. 17. U.S. Centers for Medicare & Medicaid Services. Preventive care benefits for adults. HealthCare website. https://www.healthcare.gov/preventive-care-adults/. Accessed September 28, 2018.

www.thinkscreenknow.org

Early detection matters. Refer appropriate patients for screening.

LDCT screening may be one of the most important preventive care recommendations that you can make for a patient at high risk. Having a shared decision-making conversation about the benefits and risks of screening will help you make better health decisions with your patients.1,4,7,13

Remind patients that• If they are at high risk, lung cancer screening should be considered as part of a regular health check14 • • They should think of it like other screenings, such as a mammogram or a colonoscopy1,15

• Lung cancer screening is covered by Medicare for patients 55 to 77 years old and by most commercial insurance plans for patients 55 to 80 years old.16,17

Talk to your patients about why lung cancer screening is important

IF YOU’RE CONCERNED ABOUT FALSE-POSITIVE RESULTS WITH LDCT• Data suggest that applying Lung-RADS™ (lung imaging reporting and data system) criteria to a lung cancer screening program may improve the positive predictive value (PPV), or percentage of positive screening results with cancer present, and potentially improve cost effectiveness1,10-12

•• A retrospective study published in the Annals of Internal Medicine has shown that applying Lung-RADS criteria from the American College of Radiology (ACR) to the NLST lowered the false-positive result rate. The potential effect of reduced sensitivity of the mortality benefit of LDCT in the NLST is unknown12

• Another retrospective study showed that applying Lung-RADS criteria to a clinical lung cancer screening program improved the PPV of screening from 6.9% to 17.3% (a 150% relative increase) without increasing the number of false-negative results10

LDCT scans use 75% less radiation than traditional CT scans and do not require contrast dyes8,9

†High-risk criteria: 55 to 80 years old; asymptomatic for lung cancer; smoking history of ≥30 pack-years; currently smoking or quit ≤15 years ago.7

Reduction in mortality vs chest X-ray in the National Lung Screening Trial (NLST), a study of 53,000 patientsIn the NLST, the mortality rate for patients at high risk† receiving LDCT screening for lung cancer was reduced by 20% vs chest X-ray.

Risks of LDCT screening include exposure to radiation and false-positive results.7

LDCT screening is proven to decrease mortality6

Low-dose computed tomography (LDCT) screening can detect lung cancer in patients at high risk at earlier stages, when patients have more options.1,2,4,5

*Data were collected from 2007 to 2013.

5-year relative survival is substantially higher when lung cancer is diagnosed in earlier stages3

ANNUAL LDCT SCREENING CAN DETECT LUNG CANCER IN PATIENTS AT HIGH RISK AT EARLY STAGES1,2