Should I be screened for lung cancer?

The answer to this question is not the same for everyone. Your doctor can help you decide based on your values and preferences. Quitting smoking is the most important way to lower your chances of dying from lung cancer. Quitting smoking will improve your health in other ways, too.

The main test used to screen for lung cancer is called a low-dose CT scan (or "CAT scan"). Doctors offer screening to some people in the hopes of catching lung cancer early – before it has a chance to grow, spread, or cause symptoms. If you have cancer, catching and treating it early can improve your chance of being cured and living longer.

• Lung cancer screening is recommended for people who are at high risk of developing lung cancer. To qualify for lung cancer screening, the answers to these 4 questions all need to be "Yes":
  • Are you between 50 and 80 years old? (Note that Medicare will only pay for the screening test if you are 55 to 77 years old.)
  • Do you smoke, or did you quit smoking in the last 15 years?
  • Have you smoked an amount that is equal to at least 1 pack a day for 20 years? Your doctor can help you figure this out if you're not sure. Examples of this amount include:
    • 1 pack a day for at least 20 years
    • 2 packs a day for at least 10 years
    • 3 packs a day for at least 7 years
  • Is your health good enough to get treatment if you do have cancer? (Your doctor can help you answer this question.)

• In general, the best chance for cure is treating lung cancer early, before it can spread.
• Some cancers found by screening tests are slow growing and would not cause harm for many years. That means you could go through treatment for a cancer that would not have caused you harm anytime soon. It is nearly impossible for doctors to tell which cancers will progress and which won't. Thus, almost all lung cancers are treated when possible.
• Some people feel better having as much information as possible. Other people prefer to take a "wait and see" approach. Think about how you would feel about each of these situations:
  • The possibility of not catching cancer early, when it can still be treated and maybe cured
  • Going through tests and treatments you might not have needed if you didn't get screened

• Many, if not most positive lung cancer screening tests end up being "false positives." This means the test finds something that could be cancer but turns out not to be cancer after more testing, which usually involves more X-rays or CT scans. This can lead to unneeded worry and extra tests.

• If your CT scan test comes back positive, your doctor might suggest other imaging tests. For example, you might need another CT scan in the future to see if anything has changed.
• Or, you might need another test such as a "biopsy" to look for cancer. This test comes with some risks. The biopsy might show cancer, which means you would need more treatment. Or, the biopsy might show no cancer.
• Insurance does not always cover all the tests, so you might want to think about how much you might need to pay.

• Treatment for lung cancer might include surgery, radiation therapy, and/or chemotherapy.
• The goal of screening is to catch cancers at an early stage, when treatment is likely to cure the cancer.

• Lung cancer screening needs to be done every year, for as long as you qualify. (Refer to "Do I qualify for lung cancer screening?" above.)

• Being exposed to radiation can increase your risk of cancer. However, the radiation dose associated with low-dose CT scans is very low.
• For most people, the benefit of finding lung cancer early is much greater than the risk of radiation exposure.

• Yes – you can quit smoking. Over time, your risk of lung cancer will go down.
• Tell your doctor if you have new or worse symptoms such as coughing, trouble breathing, coughing up blood, chest pain, or weight loss.