Lung cancer is the leading cause of cancer-related death in the United States for both men and women. In fact, the American Cancer Society estimates that more than 155,000 people will die from lung cancer this year. One of the reasons lung cancer is so deadly is its lack of early symptoms: most cases go unnoticed until the disease has spread beyond the lungs, making treatment less effective.
The good news is that lung cancer screening with low-dose computed tomography (CT)—which delivers less than a quarter of the radiation dose of diagnostic CT—can find tumors in the lungs before the cancer spreads to other parts of the body. Clinical trials at The University of Texas MD Anderson Cancer Center and elsewhere have shown that low-dose CT screening, compared with a standard chest x-ray, reduces the risk of dying from lung cancer by 20% in people at high risk of the disease.
Risk factors and screening guidelines
Cigarette smoking is the most common cause of lung cancer, and the disease tends to develop in older adults. With these risk factors in mind, the clinical trials of low-dose CT screening tested its effectiveness in people who were heavy smokers over a long period. The trials’ results led to the current recommendation for annual lung cancer screening for individuals who:
- are between 55 and 74 years old,
- currently smoke cigarettes or have quit within the past 15 years,
- have a smoking history of at least 30 pack-years (30 pack-years = 1 pack of cigarettes per day for 30 years, 2 packs per day for 15 years, etc.), and
- are in reasonably good health.
Some people who do not meet these guidelines may be eligible for lung cancer screening at MD Anderson in a clinical trial (No. 2013-0609) that extends the criteria to include individuals as young as 50 years or older than 74 years as well as people with a 20 pack-year smoking history and one or more additional risk factors. These risk factors include exposure to radon or other toxins, a history of other cancers or lung disease, or a family history of lung cancer.
It’s important to remember that if you have symptoms that are concerning, you don’t need to meet screening criteria to be evaluated. No matter what your specific age or smoking history, you should see your doctor if you experience symptoms such as a cough that won’t go away, infections that don’t get better, unexpected weight loss, voice change, or chest pain.
Insurance and planning
If you meet the guidelines listed above, your medical insurance or Medicare may cover lung cancer screening. Medicare requires that patients have a written order from their physicians and undergo counseling about the potential harms and benefits of screening.
Your doctor may be able to help you find a facility in your area that offers lung cancer screening. In the Houston area, you can be screened at MD Anderson’s main campus in the Texas Medical Center or at MD Anderson’s location in Sugar Land.
Your screening appointment
Like most centers that provide low-dose CT screening for lung cancer, MD Anderson offers counseling sessions before screening so that you understand the potential harms and benefits of screening. During this session, the counselor explains that an abnormal finding does not necessarily mean you have cancer. Abnormal findings may require careful watching with another CT scan in a few months; or another type of test, usually a needle biopsy, may be done to tell whether a lesion seen on CT screening is cancerous.
The low-dose CT scan takes only a few minutes and does not require any contrast liquid to be swallowed or injected. Patients and their referring physicians receive the results within a couple of business days, along with information about any follow-up tests that may be needed.
If you are a current or former smoker with a high risk of lung cancer, talk to your doctor about lung cancer screening. It’s also important to remember that lung cancer screening is not a substitute for quitting smoking. The best thing that you can do to avoid dying of lung cancer is to quit smoking and to stay tobacco free.
– B. Tutt
For more information, talk to your physician; call MD Anderson’s Lung Cancer Screening Clinic at 888-774-3020, 877-632-6789 (Medical Center), or 281-566-9012 (Sugar Land); visit MD Anderson’s Lung Cancer Screening Clinic at http://bit.ly/2jRAonQ, MD Anderson’s Tobacco Treatment Program at http://bit.ly/2lgV4H5, or the American Lung Association at www.lung.org.
OncoLog, March 2017, Volume 62, Issue 3