A Lung Cancer Screening Could Save Your Life—Are You Eligible?

By Matthew Puc, MD, and Walter Boris, DO—Virtua Thoracic Surgeons

Many people aren’t aware that a lung cancer screening exists. For those who know about it, many incorrectly believe they’re not eligible or are concerned that the test won’t be covered by insurance. 

Additionally, people don’t want to be judged for smoking or feel pressure to quit. Some smokers view a lung cancer diagnosis as inevitable, or as a punishment for their decision to smoke. As a result, they avoid discussing their smoking habits and lung cancer screening options with their doctor. 

Regardless of your current smoking status, lung cancer screening could save your life. 

Here’s what you need to know about lung cancer screening, including who’s eligible, how it works, and the risks and benefits. 

Who’s eligible for lung cancer screening?

A lung cancer screening is an imaging test that doctors use to finds signs of lung cancer before noticeable symptoms develop. Early diagnosis increases your chances for successful treatment and a greater life expectancy. But, studies show that only about 5 percent of eligible people—including current and former heavy smokers—are taking advantage of this life-saving test. 

The National Comprehensive Cancer Network (NCCN) recommends yearly lung cancer screening for people who fit into one of the two following categories: 

Category 1

• Age 55 to 74; and
• Current or former smoker (must have quit within the last 15 years); and
• 30 pack-year history* 

Category 2

• Age 50 or older; and
• 20+ pack-year history*; and
• One additional risk factor: occupational exposure, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, emphysema or chronic bronchitis, immediate family member with history of lung cancer or patient history of cancer

*A pack year is the number of packs smoked daily multiplied by the number of years smoking. Example: 1 pack a day x 30 years = 30 pack-years 

Because only 10-15 percent of lung cancers occur in people who never smoked, lung cancer screening is only recommended for older people who have a history of smoking. 

Most health insurance companies, including Medicare and Medicaid, cover lung cancer screening for people who meet the eligibility criteria.

How is lung cancer screening performed?

Lung cancer screening is a noninvasive, painless imaging test that’s performed using low-dose radiation computed tomography (LDCT) technology, also called a low-dose CT. This type of CT uses 75% less radiation than a regular CT and doesn't require needles. During the test, an imaging machine creates detailed pictures of your lungs. Your doctor checks these images looking for suspicious areas. 

Studies show that LDCT scans provide better lung cancer screening results than traditional X-ray imaging. In fact, a 2011 landmark study, the National Lung Screening Trial, showed that eligible people who were screened for lung cancer using LDCT had a 20 percent lower risk of dying. LDCT scans also reduce radiation exposure. 

What are the benefits of lung cancer screening?

The primary benefit of lung cancer screening is that it can identify signs of lung cancer early, when the disease is most treatable. Lung cancer—the leading cancer killer of men and women in the U.S.—often doesn’t cause noticeable symptoms until it’s in its advanced stages, when it’s more difficult or impossible to cure.

Today, approximately 75 percent of lung cancer cases are found AFTER they become inoperable. If lung cancer can’t be treated with surgery or if it has spread to other areas of the body, the cancer care team may recommend treatment that includes:  

• Radiation
• Chemotherapy
• Radiosurgery (pinpoint radiation of tumors)
• Targeted drug therapy
• Immunotherapy (using the body’s immune system to fight cancer)

What are the risks of lung cancer screening?

Lung cancer screening uses imaging technology that reduces radiation exposure. However, even a small amount of repeated radiation exposure from yearly scans can increase your lifetime risk of developing cancer. 

Lung cancer screening also can lead to a “false-positive” result, which occurs when follow-up tests find that a suspicious area (seen in an image) actually isn’t cancerous. A false-positive can result in invasive follow-up testing and lead to further radiation exposure. You can lower your risk of a false-positive result by having your test at an imaging center that routinely performs lung cancer screening using state-of-the-art lung imaging technology. 

What should you do now?

Talk to your doctor about screening. If you think you might meet lung cancer screening criteria, ask your primary care physician about the test. Your doctor can help you weigh the risks and decide if the test is right for you. 

Get help to quit smoking. If you’re a current smoker who’s ready to quit, help is available. Talk to your doctor about quitting smoking in a way that works for you—whether you decide to go cold turkey, take medication, or use nicotine-replacement products. 

Learn more about lung cancer screening and surgery at Virtua, or call (856) 247-7370 and press #2 to speak to a lung nurse navigator who can assist you with eligibility questions and referrals. 

Updated January 17, 2019