Lung Cancer Screening: What You Need To Know

Early detection of lung cancer increases your odds of successful treatment and celebrating more birthdays. But a lung cancer screening comes with a few risks, too. So, should you get checked?

The American Cancer Society, American Lung Association and the U.S. Preventive Services Task Force (USPSTF) say “yes” if you meet certain criteria tied to long-time cigarette use.

Let’s take a closer look at your options with pulmonologist Peter Mazzone, MD, MPH.

Who should get a lung cancer screening?

A lung cancer screening isn’t for everyone, states Dr. Mazzone. It’s recommended only for adults who are at high risk for the disease — which explains why screening guidelines are pretty specific.

The USPSTF suggests an annual lung cancer screening if all of the following apply:

• You’re between age 50 and 80.
• You’ve smoked at least 20 “pack-years” of cigarettes. (To calculate pack-years, multiply the average number of packs smoked per day by the number of years you smoked. So, 20 pack-years is one pack a day for 20 years or two packs a day for 10 years).
• You currently smoke or have quit smoking within the past 15 years.

It’s also important that you’re healthy enough to benefit from finding and treating early-stage lung cancer. People who get tested don’t typically have symptoms of lung cancer.

“If someone comes to us in a wheelchair already wearing oxygen and couldn’t tolerate treatment, they typically aren’t eligible for screening,” clarifies Dr. Mazzone. “However, there are nearly 15 million Americans who are at high risk and should receive screening.”

It should be noted, too, that a lung cancer screening is a quick and painless imaging exam. It uses low-dose computed tomography, or low-dose CT, to capture very detailed pictures of your lungs.

Why is lung cancer screening important?

As noted, lung cancer often doesn’t announce itself with early symptoms. So, without an annual screening, lung cancer is often detected once the disease has progressed and spread — which makes successful treatment less likely.

People with lung cancer have about an 80% chance of being alive five years later if the cancer is diagnosed and treatment begins during Stage 1. The five-year survival rate is about 4% if tumors have spread.

That leads us to this alarming reality: Only about 1 in 4 people with lung cancer are diagnosed before the cancer spreads. “Early detection is key to changing that,” says Dr. Mazzone.

Are lung cancer screenings perfect? Of course not. Scans sometimes detect small spots called nodules that look concerning but are basically harmless little scars. Radiation exposure is a concern, too. Ditto for overdiagnosis of conditions and additional testing and stress.

“But the benefits of lung cancer screening still outweigh any potential harm for many people,” notes Dr. Mazzone.

How often is lung cancer found during a screening?

Lung cancer is found in about 1 in every 140 people who get screened. This may sound like a small number, but it’s about the same or better than the results for breast cancer and colon cancer screening.

How to decide whether to get a lung screening

A counseling session is often required before a lung cancer screening so you can discuss lung cancer risks, the screening process, benefits and potential harm. It can be a complex and difficult decision for people to make.

“Many people value the potential benefit of screening so much they’re happy to accept them,” explains Dr. Mazzone. “Others may have a different perspective. Talk to your doctor to help decide what’s best for you.”

And because the test is annual, the decision on whether to do it can be revisited every year.