Do You Have the Facts About Lung Cancer Screening?

A screening test can help find lung cancer early, even before symptoms are noticed. Early detection helps improve the chances of successful treatment. But many people who are eligible for lung cancer screening don’t know it exists or never receive it. In fact, fewer than 1 in 5 eligible people in the United States get screened, according to the American Cancer Society.

“Lung cancer has become such a treatable disease. We want to find it early to give you the best chance of a long and fulfilling life,” said Coral Olazagasti, MD, an American Society of Clinical Oncology (ASCO) expert in lung cancer and a medical oncologist at the University of Miami’s Sylvester Comprehensive Cancer Center.

Other cancer screening tests, like mammograms and colonoscopies, have become familiar. But people may not know about the test to detect lung cancer early.

When lung cancer is diagnosed at its earliest stage, the 5-year relative survival rate is about 6 times higher than if the cancer has spread to distant parts of the body.

Who should be screened for lung cancer?

People who used to smoke may think that once they stop, their risk drops. While quitting can greatly improve a person’s health, past tobacco use still raises the risk of developing lung and other types of cancer later in life.

The American Cancer Society recommends yearly lung cancer screening for people who meet all of the following criteria:

• Are 50 to 80 years old
• Have at least a 20 pack-year smoking history
• Currently smoke or used to smoke, no matter how long ago they quit

“If you don’t know whether you qualify, ask your doctor,” said Dr. Olazagasti. “We don’t want to put the responsibility on you. We want to help guide you.”

Is a low-dose CT scan used for lung cancer screening?

Some people have concerns about radiation exposure from lung cancer screening. The recommended annual lung cancer screening test uses a low-dose CT (computed tomography), or LDCT, scan. “It’s not the same as a standard CT scan. It’s specifically designed for screening to use a much lower dose of radiation while still giving us detailed pictures of your lungs,” said Dr. Olazagasti.

The amount of radiation is similar to about 6 months of background exposure from everyday surroundings. “It’s more risky to have a lung cancer silently growing than it is to be exposed to this small dose of radiation,” said Dr. Olazagasti.

An LDCT scan is normally fast and painless. Once started, this noninvasive test takes less than a minute. It does not require diet changes and does not use a scope or needles. During the screening, you lie on a table that moves through a doughnut-shaped scanner. You stay awake the whole time and can go home afterward.

If the scan shows nothing concerning, your doctor will let you know and help you schedule a screening for the next year. However, sometimes the test finds an abnormality in or near the lungs. Most of these spots or nodules are not cancer.

If something does show up on your scan, your doctor may recommend repeating the scan as a follow-up to your initial screening. Or they may want to do other tests to look closer at what was found. Sometimes a biopsy may be needed to know if the area of concern is cancer or not. Either way, they’ll discuss the results and next steps with you.

Is lung cancer screening covered by insurance?

Costs and insurance coverage for medical testing are a common worry. Lung cancer screening is generally covered for eligible people. For example, this screening is covered by Medicare and by many private health insurance plans. Most state Medicaid programs also cover lung cancer screening, but age ranges and plan rules vary by state.

Your healthcare team can help you find out if your insurance will provide coverage for this screening and if you may have any out-of-pocket expenses.

Can lung cancer screening save lives?

Researchers estimate that if everyone in the US who qualifies got the test, it would save 62,000 lives over 5 years.

Feelings of guilt or fear of blame may discourage people from sharing their smoking history and getting the screening they need. Doctors and nurses offer a safe space to talk openly about personal risk factors.

“I strive to tell my patients this is a judgment-free zone. I won’t judge you for anything that you did in the past or even anything that you’re doing right now,” said Dr. Olazagasti. “No one deserves to have cancer.”

If you are between the ages of 50 and 80 and have a history of smoking, ask your healthcare provider about lung cancer screening. While most people who get screened do not have lung cancer, finding it early can improve the chances of successful treatment. “We have really good treatment options, people are living longer, and we have high chances of a cure,” said Dr. Olazagasti.

Learn more from the American Cancer Society:

• Lung Cancer Causes, Risk Factors, and Prevention
• American Cancer Society Guideline for the Early Detection of Lung Cancer
• ACS CancerRisk 360
• How to Get Screened for Cancer

Dr. Olazagasti is a member of ASCO’s Patient Information Advisory Committee.