Lung Cancer Screening

Cancer screening is the process of looking for a cancer before signs or symptoms develop. Cancer is easiest to treat while it is still localized and has not spread to other parts of the body, which is why screening can be a useful preemptive measure.

Not all types of cancer have a screening procedure. Lung cancer screening is generally recommended for individuals with high risk, but is not right for everyone.

Screening for Lung Cancer

There are three types of lung cancer screening. When lung cancer screening is recommended for an individual, it is usually a low-dose CT scan as this method is the only type that reduces the risk of dying from lung cancer.

Types of lung cancer screening:

• Low-Dose CT Scan: A specialized X-ray that uses low doses of radiation to take a series of pictures of your lungs and chest. A computer combines these pictures into a detailed 3-D visualization. This type of screening procedure is the only one that reduces the risk of dying from lung cancer.
• Sputum Cytology: A sample of mucus from lungs is taken and viewed under a microscope to look for signs of cancer cells.
• Chest X-ray: An X-ray of the chest is taken to look for signs of cancer. Chest X-rays are an older type of screening that are rarely used.

Lung cancer screening is not right for everyone. Your doctor can help you decide if lung cancer screening is right for you.

Who Should be Screened?

Lung cancer screening is usually recommended for people who do not have symptoms but are at high risk of developing lung cancer. A person’s risk for lung cancer depends largely on their smoking history and age.

The US Preventive Services Task Force recommends yearly screening for individuals who meet the following criteria:

• People who have a history of heavy smoking AND
• Currently smoke or have smoked within the past 15 years AND
• Are between 55 – 80 years old

The definition of heavy smoking is 30 pack years or more. A pack year is defined as an average of one pack of cigarettes per day for one year. This means that the duration of time can vary depending on individual habits. A pack year can be one pack a day for 30 years, 2 packs for 15 years, and so on.

Lung Cancer Screening Risks

All lung cancer screening tests have potential risks. These risks are outlined below, but should be considered along with consultation with your doctor. Your doctor can answer any questions you may have about screening risks and benefits.

Lung cancer screening risks include:

• False-Negative Test Results: A screening test does not show signs of cancer even though a cancer is present. No treatment is given even though it may be necessary.
• False-Positive Test Results: A screening test shows signs of cancer when a cancer is not actually present. Additional tests and treatments are given when they are not needed.
• Overdiagnosis: Overdiagnosis occurs when a cancer has been identified and treated even though it is asymptomatic or has not bothered the individual before, and which may not become life-threatening. In these cases, it is unknown if treatment will help a patient live longer or if treatment will cause more harm or lead to late-term side effects.
• Chest X-rays and low-dose CT scans are a source of radiation exposure to otherwise healthy people, potentially increasing the chance of developing cancer later.
• A biopsy for lung cancer may cause damage or a collapse of the lung.
• Cancer screening tests may not help you live longer.

Your doctor will help you determine if you are at high risk for developing lung cancer. Together, you will weigh the risks and benefits of screening so that you can make an informed decision about your health.