Is Lung Cancer Screening Right for You?

You may have heard about CT (computed tomography) scans to detect lung cancer. Screening saves lives—but it works better for some people than others.

Low-dose CT scans of the chest can spot lung cancer early, when doctors have a chance of curing it. However, the test has risks as well as benefits. For one thing, it sometimes produces false positives (you’re told you have cancer but you actually don’t). What’s more, it exposes you to small levels of radiation, which also has risks. Because of these risks, doctors  are trying to determine exactly who gains the most from lung cancer screening.

Screening Helps Those at Highest Risk the Most

In a new study, which appears in the New England Journal of Medicine, the group of patients with the greatest risk of developing lung cancer—those in the top 20 percent—saw the most benefit from undergoing scanning. They also had fewer false positives than people at lower risk.

Health experts may soon refine lung cancer screening guidelines to reflect this new information. Right now, several groups recommend the scan for anyone who meets all of the following criteria:

• Ages 55 to 79 years old
• History of heavy smoking (a pack a day for 30 years)
• Smokes now or has quit within the past 15 years

If all of these people got low-dose CT scans, it’s possible that 20 percent fewer people would die of lung cancer. The bottom line? If you smoke, or did in the past, discuss your lung cancer risk with your doctor. He or she can help you decide if screening makes sense for you.

Symptoms May Appear Late

Symptoms of lung cancer often don’t show up until the disease has advanced. The American Lung Association notes that symptoms may include:

• A cough that doesn’t go away and gets worse over time
• A chronic cough or “smoker’s cough”
• Hoarseness
• Constant chest pain
• Shortness of breath, or wheezing
• Frequent lung infections, such as bronchitis or pneumonia
• Coughing up blood

How to Breathe Easier

Whether or not you need screenings, you can reduce your risk by testing your home for radon and avoiding all smoke, whether from your own tobacco products or others’. More research is under way, but some studies show that people who eat a lot of fruits or vegetables and are physically active have a lower risk of lung cancer.

Sources

“American Association for Thoracic Surgery Supports USPSTF Recommendation for Lung Cancer Screening.”American Association for Thoracic Surgery, August 2013, www.newswise.com/articles/view/607079?print-article.

“Lung Cancer Screening (PDQ).” National Cancer Institute, November 2012. www.cancer.gov/cancertopics/pdq/screening/lung/Patient/page1

“Lung Cancer Prevention (PDQ).” National Cancer Institute, www.cancer.gov/cancertopics/pdq/prevention/lung/Patient/page1/AllPages.

“Targeting of Low-Dose CT Screening According to the Risk of Lung-Cancer Death.” S. A. Kovalchik et al. The New England Journal of Medicine. Vol. 369, no. 3, pp. 245-54, www.nejm.org/doi/full/10.1056/NEJMoa1301851.

“Final Recommendation Statement, Lung Cancer: Screening.” U.S. Preventive Services Task Force, December 2013. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/lung-cancer-screening

“What Are the Symptoms of Lung Cancer?” American Lung Association, www.lung.org/lung-disease/lung-cancer/learning-more-about-lung-cancer/understanding-lung-cancer/symptoms.html.