Should You be Screened for Lung Cancer

By Dr. Kelly McGrath

Each year, approximately 150,000 Americans die of lung cancer in the United States. This makes lung cancer the leading cause of cancer deaths in the United States. One of the main reasons the death rate is so high for lung cancer is that most patients are diagnosed at a late stage where 5-year survival rates are disappointingly low at about 18%. Alternatively, when diagnosed early, lung cancer has a 5-year survival rate of 92%. While it is best to prevent lung cancer, the next best strategy is to diagnose it early at a stage where survival is substantially better than the late stages at which most patients are diagnosed. The best way to make an early diagnosis of lung cancer is through a test called low-dose lung CT which is done annually for patients at high risk for lung cancer due to their history of smoking.

It is estimated that 85 to 90% of all lung cancers are related to a history of smoking. The most effective strategy to reduce lung cancer deaths is to reduce the rate of smoking. Already, the death toll from lung cancer in the United States has started to decrease as less Americans smoke. Because of this connection with smoking, current smokers or former smokers who have smoked more than 1 pack/day for 20 years or the equivalent in their lifetime should consider screening by low-dose CT scan. An equivalent to smoking 1 pack/day for 20 years for example is someone who smoked a half pack per day for 40 years.

Low-dose CT screening for lung cancer is a CT scan of the chest which has about 1/6th of the radiation exposure of a standard CT scan of the chest. It does not require any special contrast material to be injected in the vein and is an effective tool in diagnosing early-stage lung cancer. To be effective over long term, it should be done annually. It is recommended for patients between age 50 and 77 years. For those patients who stop smoking more than 15 years prior, the risk of developing lung cancer is low enough for that group that it is not typically recommended for those people.

The decision to screen for lung cancer depends on factors related to a person’s general health and their individual comfort with the idea of screening for early cancer. For that reason, before ordering the low-dose CT, Medicare and some other insurances require an in-person counseling visit with one’s primary care provider to see if this screening makes sense. If you are a current smoker, the best thing that you can do is to stop smoking to help prevent you from developing lung cancer. The other thing to consider is to use Low-dose CT screening to identify any lung cancer at an early, curable stage. If you are a smoker or former smoker and think either or both steps interest you, schedule a visit to ask your primary provider about them.