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Should You Consider Lung Cancer Screening?

Who Should Get This Preventive Care

Depending on your age, cancer screening should be part of your preventive care. For people with a family history of cancer, earlier and more frequent cancer screenings may be recommended. You may be familiar with a Pap test for cervical cancer, a mammogram for breast cancer, a PSA test for prostate cancer and a colonoscopy for colorectal cancer. For people with a personal history of smoking, lung cancer screening is now strongly recommended as a way to detect cancer early, when it is easiest to treat.

Lung cancer can spread silently.
— Eric M. Hart, MD

According to American Cancer Society, lung cancer is the leading cause of cancer-related death in the United States; it accounts for almost 25% of all cancer deaths.

"Lung cancer can spread silently, and often you'll have no symptoms until it becomes more advanced or has spread to other parts of the body," says Northwestern Medicine Thoracic Imaging Physician Eric M. Hart, MD. "This is why screening for lung cancer is so important if you meet the criteria."

Who Should Get Screened for Lung Cancer

The U.S. Preventive Services Task Force (USPSTF) has broadened screening guidelines. You should consider lung cancer screening if you meet all of the below criteria:

  • You are between the ages of 50 and 80.
  • You currently smoke cigarettes or quit smoking within the past 15 years. According to the Centers for Disease Control and Prevention (CDC), about 80% to 90% of lung cancer deaths in the United States are associated with cigarette smoking.
  • You have a smoking history of at least 20 pack-years.
    • One pack-year equals smoking one pack of cigarettes (20 cigarettes) every day for one year.
    • To determine your pack-years, multiply the number of packs per day smoked by the number of years smoked.
      • For example, if you smoked one pack per day for 30 years, your formula would be 1 x 30 = 30 pack-years. If you smoked two packs per day for 15 years, your formula would be 2 x 15 = 30 pack-years.
    • Many people who smoke vary the quantity of cigarettes they smoke over time. The pack-year calculator at smokingpackyears.com can help you calculate your smoking history.
  • You do not have any symptoms of lung cancer.
    • Symptoms of lung cancer can include recent weight loss, a new cough, new hoarseness or coughing up blood.
    • If you have any symptoms of lung cancer, contact your physician immediately.

"There's good evidence that women, people of color and Indigenous people get lung cancer at lower smoking rates than white men do," says Dr. Hart. "These updated screening guidelines from the USPSTF help broaden the eligibility for lung cancer screening to catch more lung cancer in high-risk groups before it's too late."

If you are eligible for screening, your primary care physician will order it for you every 12 months. Not all types of insurance cover this screening, so check with your insurance company regarding coverage.

How Lung Cancer Screening Works

A low-dose computerized tomography (low-dose CT) scan looks for any areas of concern, such as nodules, or "spots "in your lungs. Like an X-ray, the scan takes just seconds. For most people, the exam result will be negative — nothing of significant concern will be found. For a small minority of patients, a nodule will be found that may require additional follow-up or further testing. For a very small number of patients, that further testing might include a biopsy, a procedure to remove a tissue sample for analysis by a pathologist.

Traditionally, a biopsy procedure is performed by itself, and getting the results might take an additional two or three days. However, Northwestern Medicine offers an innovative, same-day robotic procedure called Ambulatory Precision Lung Sparing (A-PLUS) surgery. This technique allows surgeons to determine what the spot might be — such as a lung nodule or tumor — and remove it in one procedure, all while preserving as much lung tissue as possible. This means you can get a lung cancer diagnosis and have the cancer removed in one day. A-PLUS shaves down the time between diagnosis and treatment, which is critical for achieving better outcomes with a disease like lung cancer that can spread so silently and quickly.

Snuffing Out the Stigma

"One of the problems that we run into with lung cancer screening is that there's a stigma related to smoking or having been a person who smoked," says Dr. Hart. "This stigma can prevent people from seeking the care they need. We're hoping to reduce or eliminate the stigma of smoking so that people can feel free to come in, be screened and receive this intervention that could save their life."

Smoking is simply part of your personal health history. If you have a significant smoking history, lung cancer screening should be part of your routine preventive care.