About The Author
Dr. Mario Gasparri
Froedtert & the Medical College of Wisconsin Health Network
Lung cancer is the second most common cancer in American men and women. In 2018 alone, it’s expected to cause more than 150,000 deaths. The high death rate is partly a result of late cancer detection – symptoms are rarely present during the earliest stages. For eligible individuals, this makes regular lung cancer screening the best option for catching the disease during its earliest, most treatable stages. Lung cancer screening means getting an imaging exam called a low-dose computed tomography (CT) scan.
To be eligible for lung cancer CT screening, you must be considered at high risk for the disease:
- Ages 55-74
- A history of smoking that is greater than 30 pack years (1 pack/day for 30 years)
- Current smoker or quit less than 15 years ago
How often you need to get screened depends on the results from your first scan. If everything is normal, you’ll get screened annually. If the scan shows an abnormality, you may need to get scanned more often.
Before getting the CT scan, you’ll need to:
- Take part in a shared decision-making visit with your doctor to review the risks and benefits of participating in a lung cancer screening program
- Receive counseling on the importance of smoking cessation and information about smoking cessation programs or interventions (Medicare may pay for this)
With a lung cancer CT screening, the radiation dose is less than one-fourth the radiation of a regular CT scan. There are no injections and intravenous contrast is not needed. The radiologist and your doctor will review the results and look for any nodules or spots on your lungs that may indicate lung cancer. Your doctor will then recommend continued screening at appropriate intervals, or, if there is a diagnosis, a treatment plan.
To get the maximum benefit of early detection, low-dose CT scans should be repeated every year for life, unless a diagnosis of lung cancer requires a different schedule or the screening can no longer offer a benefit.
One thing to note is that there is a small risk for false positives. About 25 percent of scans will show an abnormality, but 90 percent of the time, it’s not cancer.
If an abnormality is discovered, it can lead to another scan or more frequent testing. Sometimes it may result in a patient undergoing a more invasive test to find out if the abnormality is cancer.
Lung cancer CT screening has been studied for decades and has been available for several years. However, prior to 2015, when Medicare began covering lung cancer screenings for those who were eligible, people typically had to pay for screenings out-of-pocket. The Froedtert & the Medical College of Wisconsin health network bases its screening protocol on National Comprehensive Cancer Network guidelines. If lung cancer is diagnosed, every patient is evaluated by the Froedtert & the Medical College of Wisconsin Cancer Network’s multidisciplinary thoracic tumor board to ensure all treatment options are considered and each patient receives the right treatment for his or her situation.