Early detection saves lives. This truism applies to lung cancer even more so than other types of cancer, as the life-saving rate of CT scans for lung cancer is significantly higher than that for colon, prostate, or breast cancer screening.

Lung cancer is the second-most common cancer in both men and women in America, and is the leading cause of cancer deaths. Only 17% of patients diagnosed with lung cancer live five years or more, though this rate improves to 52% if the cancer is caught early; this is why lung cancer screening with CT scans is so impactful and so important! Lung cancer is often diagnosed after it has spread because many patients don’t have symptoms like cough or shortness of breath until relatively late in the disease process; this is why screening before people feel sick makes such a difference.

What is screening?
Lung cancer screening means looking for signs of cancer before people feel sick; this is most effectively done with a CT scan specially designed for this purpose. Foundation Health Partners has a new Lung Cancer Screening Program that includes a CT scan but also offers a lot more, from counseling by skilled nurses to comprehensive follow-up support. Chest X-Ray has been used traditionally, but CT scan is preferred presently due to a 20% reduction in lung cancer deaths in a 2002 study.

What is a low-dose CT?
The only recommended screening test presently for lung cancer is low-dose computed tomography (low-dose CT scan, or LDCT). An LDCT scan is a special kind of X-ray that takes multiple pictures. These pictures are combined into a detailed image of your lungs. For a CT, you lie on a table that slides into thin machine, which uses a low dose of radiation to create detailed images of your lungs. The scan only takes a few minutes and is not painful. The “low-dose” part means that the scan is specially designed to expose the patient to less radiation while still getting great pictures.

Who should consider screening?
There are a clear set of guidelines about which patients benefit lung cancer screening. Patients between 55 and 80 with a heavy smoking history and who are still smoking or have quit within the past 15 years are the recommended population, as long as they don’t have symptoms.

Heavy smoking means a smoking history of 30 pack years or more, or an average of one pack of cigarettes per day for one year. This could be smoking one pack a day for 30 years or two packs a day for 15 years. If your smoking habits have changed over the years, talk to your primary care provider to determine whether lung cancer screening may be beneficial for you. If you were a heavy smoker for a long time and you quit smoking, a LDCT lung cancer screening may be recommended.

Who should not pursue this type of screening?
If you have poor lung function or need continuous supplemental oxygen, have experienced unexplained weight loss in the past year, have coughed up blood recently or have had a chest CT scan in the last year, the recommendation is to be treated directly for these symptoms and address your lung health that way.

Will insurance cover a lung cancer screening test?
If you meet the high-risk criteria mentioned above, most health insurance companies cover lung cancer screening. For people on Medicare, the Centers for Medicare and Medicaid Services covers an LDCT lung cancer screening for people 55 to 77 with a 30 pack year history of smoking who are either current smokers or who have quit smoking in the last 15 years. Other insurances cover ages 55-80.

It is always a good idea to check with your health insurance provider to be sure lung cancer screening is covered under your plan.

Things to Consider
For 25% of people, a screening Chest CT will find tiny spots on the lungs called lung nodules. In most cases, these lung nodules are harmless scarring of the lung tissue. In about 4% of people screened, the nodules are cancerous. If the nodule is large enough, a procedure called a biopsy may be necessary. This test allows the doctor to see what kind of cells make up the nodule. If the nodule is small, further CT scans are ordered over time to assess if the spot is getting bigger.

Discuss the benefits and the risks of lung cancer screening using LDCT with your primary care provider. Work together with your health care team to decide whether screening is right for you. 

Smoking cessation
Smoking cessation remains the most important step to minimize the risks of Lung and many other types of cancer. LDCT lung cancer screening is not a good alternative to stopping smoking. By quitting, smokers can lower their risk of developing and dying from lung cancer. 

If you smoke, and are trying to stop, counseling might help. One resource is Alaska’s Tobacco Quit Line: 1-888-842-QUIT (7848). Alternatively, you can talk to your doctor about your risk of lung cancer and to get a referral to a smoking cessation program.