Patient education: Lung cancer screening (The Basics)

What is lung cancer screening? — 

This means checking the lungs for early signs of cancer in people who have no symptoms of lung cancer. The goal of screening is to find lung cancer early, before it has a chance to grow, spread, or cause problems.

Doctors suggest screening for certain people who are at high risk of lung cancer because they smoke, or used to smoke. Although screening is not likely to help for everyone who smokes, doctors think it might help prevent cancer deaths in people who smoke a lot or smoked for many years, even if they already quit.

Doctors recommend a test called a "low-dose CT scan" to screen for lung cancer. It uses much less radiation than a typical CT scan and shows a more detailed image of the lungs than a standard X-ray. (Chest X-rays do not work for screening for lung cancer.)

The best way to lower your chances of getting lung cancer or dying from it is to quit smoking. No matter how much or how long you have smoked, quitting is a good idea. Quitting now will reduce your chances of lung problems, heart disease, and many forms of cancer.

Can I be screened with a standard X-ray instead of a low-dose CT scan? — 

There is no proof a standard X-ray for screening helps extend life. Experts do not recommend chest X-rays as a way to screen for lung cancer.

Who should be screened for lung cancer? — 

Screening people who have smoked a lot or for a long time can help save lives.

If the following 3 statements are all true for you, ask your doctor about screening:

●You are 50 to 80 years old.

●You have smoked an amount that is equal to at least 1 pack a day for 20 years (for example, 2 packs a day for 10 years).

●You still smoke now, or you quit smoking in the past 15 years.

In addition to your smoking history, the decision to be screened should also consider:

●Your general health – Think about whether your health is good enough to get treatment if screening shows you have cancer. Your doctor can help you answer this. If your overall health is poor, lung cancer screening might not be recommended.

●The costs involved in screening – If you are thinking about screening, check with your insurance company to find out if they will cover some or all of the cost. You can also ask your doctor's office what you might have to pay. If you have Medicare, they will cover lung cancer screening if you are 50 to 77 years old. It's important to be aware of this age limit if you are older than 77.

What are the benefits of being screened for lung cancer? — 

The main benefit is that it helps doctors find cancer early, when it is usually easier to treat. This might lower your chances of dying of lung cancer.

What are the possible risks of being screened? — 

The risks include:

●False positives – Low-dose CT scans can sometimes show a "false positive," meaning it suggests a person might have cancer when they do not. This can lead to unneeded worry and to more tests. For example, people who have a false positive might need to have a follow-up full-dose CT scan, which exposes them to more radiation. They sometimes also need a lung biopsy, which is a procedure to remove a small sample of lung tissue. The biopsy can be painful and can sometimes lead to problems, such as bleeding or a collapsed lung.

●Radiation exposure – Like all X-rays, CT scans expose you to some radiation. Although the radiation dose from a screening CT scan is low, you would need to have a scan every year for continued screening.

CT scans show other organs near the lungs. Sometimes, they can find things in other organs that do not look normal. If this happens, it can lead to more tests to make sure what they found is not cancer.

What happens during a low-dose CT scan? — 

When you have a low-dose CT scan, you lie on a sliding table. The CT scan machine is shaped like a giant donut, and you slide through the large hole in the center. As you slide through, the machine takes pictures of the inside of your body. The process only takes a few minutes and does not hurt.

What happens after a low-dose CT scan? — 

You should get a phone call or letter with your results. If you do not hear back about your results in about 2 weeks, call your doctor's or nurse's office. Do not assume your scan was normal if you hear nothing.

What if my CT scan is abnormal? — 

Try not to panic. More than 95 out of 100 people with an abnormal scan turn out not to have lung cancer. But you will need more tests to find out if you actually have cancer.

How often should I have a low-dose CT scan for screening? — 

If you and your doctor decide you should be screened, you need to get a low-dose CT scan once a year if your scans continue to be normal. You can stop getting screened at age 80 or once you have gone 15 years or longer without smoking. But remember Medicare does not cover screening for people older than 77 years.

More on this topic

Patient education: Cancer screening (The Basics)
Patient education: Lung cancer (The Basics)
Patient education: Non-small cell lung cancer (The Basics)
Patient education: Small cell lung cancer (The Basics)
Patient education: Quitting smoking for adults (The Basics)
Patient education: Quitting smoking for teens (The Basics)
Patient education: CT scan (The Basics)

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Patient education: Small cell lung cancer treatment (Beyond the Basics)
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