Should I Be Screened for Lung Cancer?

Pictured above (left to right): hematology specialist Mitchell Carl, MD, and medical oncologist James Kalmuk, MD

The lung cancer death rate has declined significantly over the last few decades. In part, this is due to a decrease in the prevalence of smoking, and from improvements in early detection and treatment that is more effective. Even so, lung cancer remains the leading cause of cancer deaths in the U.S., affecting nearly 240,000 Americans every year.

Last year, the American Cancer Society unveiled changes to its lung cancer screening recommendations aiming to remove barriers to screening and identify more cancers early, when they are easier to successfully treat.

The new guidelines lowered the age for annual lung cancer screening among asymptomatic (no symptoms) former or current smokers from 55-74 years to 50-80 years. As a result, an additional 5 million people will be eligible for screenings.

The update also now considers a high-risk person as anyone with a 20-pack-year history*, down from a 30-pack-year history, and removes the requirement that former smokers must have quit within 15 years to be eligible for screening.

Still not sure you want to get a screening? Consider this:

Lung cancer is so deadly because most people are not diagnosed until a very late stage. Symptoms of lung cancer often do not appear until the disease is already at an advanced stage. Even when lung cancer does cause symptoms, many people may mistake them for other problems, such as an infection or long-term effects from smoking. 

Screening asymptomatic patients means catching lung cancer earlier and improving the chances the cancer can be managed with less aggressive treatments with more favorable side effects than the treatments used for late-stage patients.

Lung cancer screenings are performed using a low-dose CT scan (LDCT). For this test, you lie on a narrow table that slides through a CT scanner, which is a large, doughnut-shaped machine. The scan is painless and takes only a few minutes, although the entire visit (including getting you ready and into place on the table) can take up to half an hour. No injections are required.

If your screening reveals something abnormal in the lungs, additional scans or other tests may be recommended.  

Still unsure? Consider one last thing:

The five-year survival rate for early-stage lung cancer is much higher (63%) than the survival rate (8%) for those diagnosed at a late stage.

Boost your odds today by calling your doctor to discuss scheduling a screening.

*Your pack-year history is determined simply by multiplying the number of packs per day by the number of years smoking. For example, a person can have a 20 pack-year history by smoking 1 pack a day for 20 years, or by smoking 2 packs a day for 10 years.

Matthew Vernon, MD, is a radiation oncologist at the Dartmouth Regional Cancer Center at Southwestern Vermont Medical Center