Lung Cancer Screening

It’s the number-one cancer killer of both men and women.  Almost 160,000 Americans died in 2016 from this cancer, and it accounts for over 25% of all cancer deaths in the USA.

We have no effective chemotherapy treatment for most cases of this cancer.  Once it spreads, it cannot be cured.

The most effective treatment for this cancer is surgery, but the vast majority of cases have no symptoms until the tumor is advanced.

Until recently we had NO way to screen for this cancer.

This is, of course, lung cancer.  One of the most feared and most difficult to treat tumors in humans, it usually spreads to the bone, the liver, the adrenal glands and the brain.  It is strongly associated with smoking and with second-hand smoke exposure, as well as with some occupational exposures like to radiation, asbestos and radon gas.

After years of research and the development of new less-costly and less-harmful technology, we finally have an effective tool for lung cancer screening.

In 2015 Medicare approved the use of low-dose CT scanning for screening for lung cancer in certain patients.  Most private insurers and Medicaid also cover this screening test although you should check whether your carrier offers this test.

Who is at risk for lung cancer and eligible to be screened?

  • Age 55-77, both men and women
  • NO signs or symptoms of lung cancer like a chronic cough, fevers, night sweats, coughing up bloody phlegm, or unexplained weight loss
  • Current smoker or quit smoking within the last 15 years
  • At least 30 pack-years of smoking history (an average of 1 pack per day for 30 years, 1 ½ pack per day for 20 years, or 2 packs per day for 15 years, for example)

It’s not a one-and-done screen though.  Like mammography, low-dose CT for lung cancer screening needs to be performed every year.  Often there are tiny nodules found on screening that may be scars, may be evidence of old infections, or may be very early lung cancers.  These need to be followed over time to make sure they are not changing and that no new spots develop.

One other important thing to realize is that although the screening CT is covered by Medicare at no cost sharing (like mammograms, Pap tests and bone density tests), any follow up done because of an abnormality WILL have an associated cost based on deductibles and copays.

It is also important to know that an abnormal screening scan produces a LOT of anxiety.  It’s very hard to hear that you have a 1/8-inch spot in your upper left lung, which is too small to biopsy or to scan in any other way, so we’re going to leave it alone and repeat the scan in 6 months.  Wait, what?!  What am I going to do for the next 180 days and nights until it’s time to scan again?  Wait, and worry, unfortunately.

If you meet the criteria above and are interested in being screened for lung cancer, make an appointment to talk to your doctor about it.  This should happen at a well visit so if you haven’t had your physical in over a year you should definitely call and schedule it.

Lung cancer kills more Americans than any other cancer.  It is difficult to diagnose early enough to be able to treat it effectively.  Low-dose CT scanning is the best tool for lung cancer screening we’ve ever had.

PS – If you meet the criteria to be screened for lung cancer and you are still smoking, you need to cut down and quit.  Today.  I know that goes without saying, but I just needed to say it anyway.

QUESTION: Do you meet criteria for lung cancer screening?  Have you had a low dose CT scan?


One thought on “Lung Cancer Screening

  1. Yes I met the criteria and had the test twice and a biopsy and ended up with a clean bill of health. But it was stressful waiting between the 2 scans and then the biopsy.

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