Should I Get Screened for Lung Cancer?

*In March of 2021, the U.S. Preventative Services Taskforce (USPSTF) updated its lung cancer screening guidelines for the first time since 2013. This recommendation nearly doubled the number of individuals eligible for screening by lowering the recommended age range to begin screening to age 50 (from 55) as well as reducing the minimum pack-year smoking history from 30 to 20. In February 2022, the Centers or Medicare and Medicaid Services (CMS) expanded coverage for lung cancer screening with low-dose CT to meet these new guidelines. 

Each year, more people die of lung cancer than of colon, breast and prostate cancers combined. Still, a recent report showed that the cancer death rate declined sharply, especially for lung cancer and melanoma. For lung cancer, the decline is due in part to increased screening for those at high risk. While most people are well informed about mammograms, the screening for breast cancer, what is a screening for lung cancer and who should be getting them?

The screening for lung cancer is a low-dose CT scan, which can recognize tiny nodules that would otherwise go undetected -- there long before the patient has any symptoms. It also creates less exposure to radiation than a traditional CT scan. The goal is to be proactive, flagging patients who are most at risk to get screened.

For patients who meet certain criteria, like age and smoking habits, their primary care physician may recommend an annual low-dose CT scan.

• Eligible patients include those between 50-80 who have a significant smoking history

• What exactly is “a significant smoking history”? It means smoking the equivalent of one pack of cigarettes per day for 20 or more years

• This can be either currently or in the recent past, even if someone has quit smoking within the past 15 years

Patients with symptoms such as coughing up of blood or weight loss should see their physician first, before enrolling in a lung cancer screening program.

Through Baton Rouge General’s Lung Screening Clinic, a patient’s results from the low-dose CT scan go to a patient navigator and then a multidisciplinary team of clinicians for review. If the nodule seen on the scan is small enough, the team would typically recommend a follow-up scan in a year. But, if there is cause for concern, a pulmonologist will review the patient’s history and CT scan to determine next best step. This may include a follow-up appointment, additional imaging and other diagnostic tests.

After a visit at the Lung Screening Clinic, a patient may be referred to a cardiothoracic surgeon, for example, who would remove the nodule surgically. Or, the case could be brought to a team of oncologists to discuss. For many patients, the outcomes are excellent, possibly with no chemotherapy or radiation required.

If you meet the criteria or are concerned about your risk for lung cancer, ask your healthcare provider about low-does CT scans as a screening.