Lung Cancer Screening: Detecting Cancer Early to Save Lives

Lung cancer screening is a preventive measure used to detect lung cancer in its earliest stages, even before any symptoms appear, in individuals who are considered to be at high risk of developing the disease. The primary goal is to find cancer when it is small, has not spread, and is therefore more likely to be curable with treatment. Studies have shown that lung cancer screening can reduce the risk of dying from lung cancer.  

The only recommended screening test for lung cancer is a low-dose computed tomography (LDCT) scan. This is a quick and painless imaging test where you lie on a table that slides into a CT scanner, and an X-ray machine uses a low amount of radiation to take detailed pictures of your lungs.

Who Needs Lung Cancer Screening?

Lung cancer screening is not recommended for everyone. It is targeted at individuals who have a significant risk of developing lung cancer, primarily due to their smoking history and age. Current guidelines from leading health organizations, such as the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society, generally recommend annual lung cancer screening for people who meet the following criteria:

• Age: Are between 50 and 80 years old.  

• Smoking History:

  • Have at least a 20 pack-year smoking history. (A "pack-year" is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person smoked. For example, smoking one pack a day for 20 years or two packs a day for 10 years both equal 20 pack-years.)  

  • Currently smoke or have quit within the past 15 years.  

• General Health: Are in generally good health and do not have a health problem that substantially limits their life expectancy or their ability or willingness to have lung surgery if cancer is found. Screening is generally not recommended for those with poor lung function or other serious conditions that would make surgery difficult.  

It's crucial to have a shared decision-making discussion with your doctor before deciding to undergo lung cancer screening. This conversation should cover:

• Your individual risk factors.

• The potential benefits of screening (early detection and reduced mortality).

• The potential limitations and harms of screening, which can include:

  • False-positive results: The scan might show something abnormal that turns out not to be cancer, leading to anxiety and further, potentially invasive, tests.

  • Overdiagnosis: Finding cancers that might never have caused a problem, leading to unnecessary treatment.  

  • Radiation exposure: While it's a low-dose scan, there is repeated exposure to radiation with annual screening.  

• What the screening process involves.

• What happens if an abnormality is found.

For individuals who currently smoke, counseling on smoking cessation and resources to help them quit should be a part of this discussion and ongoing care, as quitting smoking is the most important step to reduce lung cancer risk.  

Screening is typically done annually. Guidelines also recommend when screening can be discontinued, such as when a person has not smoked for 15 years, turns 81, or develops a health condition that would make curative surgery too risky.  

Most insurance plans and Medicare cover lung cancer screening for eligible individuals, but it's always a good idea to check with your specific insurance provider.  

If you believe you might be a candidate for lung cancer screening based on these criteria, speak with your doctor to discuss your individual situation.