Lung Cancer Screening
Lung cancer screening is a process that's used to detect the presence of lung cancer in otherwise healthy people with a high risk of lung cancer. Lung cancer screening is recommended for older adults who are longtime smokers and who don't have any signs or symptoms of lung cancer.
Doctors use a low-dose computerized tomography (LDCT) scan of the lungs to look for lung cancer. If lung cancer is detected at an early stage, it's more likely to be cured with treatment.
Why it's done
The goal of lung cancer screening is to detect lung cancer at a very early stage — when it's more likely to be cured. By the time lung cancer signs and symptoms develop, the cancer is usually too advanced for curative treatment. Studies show lung cancer screening reduces the risk of dying of lung cancer.
Who should consider screening
Lung cancer screening is usually reserved for people with the greatest risk of lung cancer, including:
Older adults who are current or former smokers. Lung cancer screening is generally offered to smokers and former smokers 55 and older.
People who have smoked heavily for many years. You may consider lung cancer screening if you have a history of smoking for 30 pack years or longer. Pack years are calculated by multiplying the number of packs of cigarettes smoked a day and the number of years that you smoked.
For example, a person with 30 pack years of smoking history may have smoked a pack a day for 30 years, two packs a day for 15 years or three-quarters of a pack a day for 40 years. Even if your smoking habits changed over the years, your recollection about your smoking history can be used to determine whether lung cancer screening may be beneficial for you.
People who once smoked heavily but quit. If you were a heavy smoker for a long time and you quit smoking, you may consider lung cancer screening.
People in generally good health. If you have serious health problems, you may be less likely to benefit from lung cancer screening and more likely to experience complications from follow-up tests. For this reason, lung cancer screening is offered to people who are in generally good health.
Screening is generally not recommended for those who have poor lung function or other serious conditions that would make surgery difficult. This might include people who need continuous supplemental oxygen, have experienced unexplained weight loss in the past year, have coughed up blood recently or who have had a chest CT scan in the last year.
People with a history of lung cancer. If you were treated for lung cancer more than five years ago, you may consider lung cancer screening.
People with other risk factors for lung cancer. People who have other risk factors for lung cancer may include those with chronic obstructive pulmonary disease (COPD), those with a family history of lung cancer and those who are exposed to asbestos at work.
Lung cancer screening carries several risks, such as:
- Being exposed to a low level of radiation. The amount of radiation you're exposed to during an LDCT is much less than that of a standard CT scan. It's equal to about half the radiation you're exposed to naturally from the environment in a year.
Undergoing follow-up tests. If your scan shows a suspicious spot in one of your lung, you may need to undergo additional scans, which expose you to more radiation, or invasive tests, such as a biopsy, which carry serious risks. If these additional tests show that you don't have lung cancer, you may have been exposed to serious risks that you would have avoided if you didn't undergo screening.
Finding cancer that's too advanced to cure. Advanced lung cancers, such as those that have spread, may not respond well to treatment, so finding these cancers on a lung cancer screening test might not improve or extend your life.
Finding cancer that may never hurt you. Some lung cancers grow slowly and may never cause symptoms or harm. It's difficult to know which cancers will never grow to hurt you and which ones must be removed quickly to avoid harm. If you're diagnosed with lung cancer, your doctor will likely recommend treatment. Treatment for cancers that would have remained small and confined the rest of your life may not help you and may be unnecessary.
- Missing cancers. It's possible that lung cancer may be obscured or missed on your lung cancer screening test. In these cases, your results may indicate that you don't have lung cancer when you actually do.
- Finding other health problems. People who smoke for a long time have an increased risk of other health problems, including lung and heart conditions that may be detected on a lung CT scan. If your doctor finds another health problem, you may undergo further testing and, possibly, invasive treatments that wouldn't have been pursued if you hadn't had lung cancer screening.