What Current and past Smokers Need to Know About Lung Cancer Screening

If you’ve ever smoked cigarettes or are a current smoker, the risk of getting lung cancer is higher for you than people who’ve never smoked. That isn’t going to change, because smoking is the leading cause of lung cancer.

About 90 percent of lung cancer can be curable if it’s found in its earliest stages. Lung cancer screening with a low-dose computerized tomography (CT) scan is the best way to find lung cancer early and get the treatment you need.

Read below to find out if you or a loved one might be a candidate for lung cancer screening. (Note: The recommendations below are based on the National Lung Screening Trial [NLST].)

Who Should Get Screened?

Using NLST recommendations, people ages 55-77 with no signs or symptoms of lung cancer who currently smoke or who have quit smoking within the past 15 years should be screened. Individuals with the highest risk are those with a 30-pack-year smoking history (smoking a pack a day for 30 years or two packs a day for 15 years).

The Screening Process

Screening is a way to look for health problems before any symptoms show up.

Lung cancer screening is done at many hospitals, clinics, and freestanding imaging centers. Low-dose CT scan is the recommended screening method, replacing the conventional chest-x-ray.

The test is quick and painless. There’s no preparation and you can keep your clothes on. You lie on a table that moves until your chest area is inside a cylinder. Your head is kept outside so that you don’t get claustrophobic. The technician may ask you to hold your breath (to prevent blurring the images) and takes several images with x-ray beams. Then you’re done. It may take three business days or so to get the results.

Screening Frequency

The recommendation is to continue screening when you’re at high risk for lung cancer. On-going CT lung screening is recommended:

  • Every year until the age of 77; or
  • Up to 15 years from the time you quit smoking (screening stops after 15 years); or until
  • Major changes in your health status require you to stop screening

Downsides to Getting Screened

There are some risks with a low-dose CT scan, so it’s a good idea to talk to your doctor about them. Screening can lead to:

  • False-positive reading (seeing a possible cancer where there is none) that can lead to further testing and treatments that aren’t necessary.
  • Over-diagnosis or diagnosing cancers that would not have made you sicker or die earlier.
  • Radiation exposure. (Note: The amount of radiation exposure from a CT lung cancer screening is about the same as a person would receive from background radiation [such as sun exposure] over a period of one year.)

What If the Screening Finds Something Wrong?

If the CT scan shows problems, usually nodules on the lung, there may be further imaging and testing needed. Nodules are common and most aren’t cancer. Finding them may lead to a more frequent screening schedule. In some cases, surgery will be recommended.

Cost of Screening

  • A low-dose CT scan is covered by most insurance plans. If you’re not sure about yours, check with your insurance provider.
  • Under the Affordable Care Act, a low-dose CT scan is a covered “essential benefit” as of February 2015.
  • A low-dose CT scan is covered by Medicare only if specific criteria are met. Click here to read the criteria.

What to Do About Screening If You're Not at High Risk but You're Worried

If you’re too young, too old, weren’t a heavy smoker or quit more than 15 years ago, talk to your doctor. They will evaluate your health, find ways to cut your risk further, and explain what’s best for you.

The Takeaway

Lung cancer is the number one cause of cancer death for men and women in the U.S. Smoking is the biggest cause of lung cancer. Screening those at risk will save lives. Quitting smoking altogether will save even more lives. We know it’s very hard. Work with your primary care doctor to find what it takes to help you stop.

This is a good online resource to help you quit smoking: Smokefree.gov

Note: The U.S. Preventive Services Task Force also released screening guidelines (here). This article uses the NLST age range because it reflects the group actually studied.

Meet the Author

Laura Pfouts McGartland, MD is a Medical Oncologist at Aurora St. Luke's Medical Center in Milwaukee, Wisconsin.

Read more posts from this author

The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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