Lung Cancer Screening Guide: Who Needs It & What to Expect

Overview

Lung cancer screening is a preventive test used to detect lung cancer in its earliest, most treatable stages, before you notice any symptoms. The U.S. Preventive Services Task Force (USPSTF) recommends annual low-dose computed tomography (LDCT) scans for people at high risk for lung cancer. Unlike a standard chest X-ray, LDCT uses much lower radiation doses and can find small abnormal growths (called nodules) in the lungs that may be early cancer.

Signs & Symptoms of Lung Cancer

Most early-stage lung cancers cause no symptoms, which is why screening is so important for high-risk people. As the cancer grows, you may notice the following signs:

• A cough that doesn’t go away or gets worse over time
• Chest pain that is worse when you breathe deeply, cough, or laugh
• Shortness of breath, even with mild activity
• Coughing up blood or rust-colored sputum (mucus)
• Unexplained weight loss or loss of appetite
• Hoarseness that lasts for weeks
• Frequent lung infections, such as bronchitis or pneumonia

Causes & Risk Factors for Lung Cancer

Lung cancer occurs when abnormal cells in the lungs grow out of control. The biggest risk factor is smoking, which causes about 80% of lung cancer deaths. Other risk factors that may increase your chances of developing lung cancer include:

• Current smoking or a history of heavy smoking (defined as 20 pack-years or more: 1 pack per day for 20 years, 2 packs per day for 10 years, etc.)
• Long-term exposure to secondhand smoke
• Exposure to radon gas, a colorless, odorless radioactive gas that can build up in poorly ventilated homes
• Exposure to asbestos, arsenic, or other industrial chemicals
• A family history of lung cancer
• Previous radiation therapy to the chest for another type of cancer

Diagnosis: What to Expect During Screening

Lung cancer screening is a quick, painless test. You will lie on a padded table that slides into a donut-shaped CT scanner, which takes detailed cross-sectional X-ray images of your lungs. The entire scan takes less than 10 minutes, and you do not need to fast or take any special medication beforehand. A radiologist will review the images to look for any abnormal spots (nodules) in your lungs. If a nodule is found, your doctor may recommend additional tests, such as a follow-up CT scan, PET scan, or biopsy, to check if it is cancerous.

Treatment & Management if Cancer Is Found

If screening finds lung cancer in its early stages, it is often treatable with surgery, radiation therapy, or targeted therapies that attack specific cancer cells. For people who continue to smoke after a cancer diagnosis, quitting smoking is one of the most important steps to improve treatment outcomes and reduce the risk of cancer coming back. Your care team will work with you to create a personalized treatment plan based on the type and stage of your cancer.

Living With It: Reducing Your Risk

Even if your screening results are normal, taking steps to reduce your lung cancer risk is important. The single most effective step is to quit smoking if you smoke, which lowers your risk of lung cancer and many other serious health conditions, including heart disease and COPD. You should also test your home for radon, avoid exposure to secondhand smoke and industrial chemicals, and eat a diet rich in fruits and vegetables. Continue to get annual screening as recommended by your doctor if you remain at high risk.