Screening for Lung Cancer: Who, When, and How.

Can I be screened for lung cancer?

Let’s see if you qualify. 

Lung cancer is the leading cause of cancer mortality in women in the United States. However, recent years have seen a decline in lung cancer deaths partly due to advances in early detection with low-dose computed tomography (CT) scanning and treatment.

Who should be screened for lung cancer, and how? 

New guidelines just released have expanded who should be screened annually. If you fall into one of these categories, ask your primary care doctor to arrange a screening.

Adults aged 50 to 80 years old at high risk due to smoking history: If you have at least a 20 pack-year smoking history and are either a current smoker or have quit within the past 15 years, you should be screened. What does 20 pack-years mean?  For example, 1 pack per day for 20 years, a half-pack a day for 40 years, or 2 packs per day for 10 years. Know that even if you quit 15 years or less from today, you need to be screened. 

Screening consists of once a year low-dose chest CT scan. A low dose CT scan means a low dose of radiation. The scan does not need intravenous contrast (IV contrast), and it’s not the narrow/loud tube like an MRI scan.

Lung cancer screening requires an ongoing commitment. This means a single baseline study is insufficient, and you will need once yearly screening. 

What are the downsides?  You and your doctor may be chasing benign nodules. The most likely “positive” result of screening is the detection of benign nodules requiring further evaluation, and this evaluation may require invasive studies (CT-guided biopsies) and possibly even surgery. More often, benign nodules may require 3 or 6-month follow-up scans to make sure the benign nodule doesn’t change. 

Cost: Medicare and other private insurance should cover the cost of annual screening. For former smokers, annual screening should continue until 15 years have elapsed from the date of smoking cessation.

Hope this helps

Dr O.