Not sure if you need an annual screening for lung cancer? Run through this checklist with your doctor.
Finding lung cancer early is so important for a positive outcome – the easier lung cancer is found, the easier it is to treat it. That’s why regular lung screenings with low-dose computed tomography (LDCT) are crucial for people at high risk developing the disease.
But figuring out whether you are in the high-risk category can be confusing.
It is a conversation that should be held with a medical professional who can evaluate your health and your risk factors (things that increase your chances of developing lung cancer). That health care provider can advise you on whether or not this type of screening would benefit you.
The Vanderbilt Lung Screening Program offers this guide to discussing lung screening with your doctor. Ask these questions:
1. Am I at an age when lung screenings should be considered?
Lung screenings aren’t usually recommended until a person who is at a higher risk reaches 50, per the U.S. Preventive Services Task Force guidelines.
2. I’m the right age for screening, but am I at high risk of having lung cancer?
The task force recommends annual lung screenings for those who have a “20 pack-year” cigarette smoking history. That means that if you’ve smoked, on average, a pack per day for 20 years or more, you should get annual screenings. A mathematical equivalent also applies – for example, if you smoked two packs a day for 10 years, you would also meet the criteria for getting screened. People who still smoke, or those who have quit in the past 15 years, are also eligible.
3. I meet the age and smoking history criteria. How long will I need to be screened?
The task force recommends getting screened once per year every year starting at age 50 until a person reaches age 80, or has not smoked in the past 15 years. If a patient develops a health problem that significantly shortens their life expectancy, or the individual isn’t willing or able to undergo a surgery or treatment in the event of a cancer diagnosis, the recommendation is to stop screening.
4. I do not meet the age and smoking history criteria. Should I still be screened?
Most health insurance plans won’t cover screening unless an individual meets the criteria under the USPSTF guidelines. However, patients can pay for the test out of pocket if they prefer.
Vanderbilt’s program checks people who are younger than 50 and also those who do not meet the smoking criteria, if they have a referral from their doctor, said Dr. Kim Sandler, the program’s co-director. Some people still want the screening, even if their insurance does not cover it.
If you have a family history of lung cancer, a history of other cancers, or have been exposed to carcinogens on the job, you should discuss those additional risk factors with your health care provider. Together you can make a decision about whether screening makes sense for you. According to the National Comprehensive Cancer Network, carcinogens that target the lungs include the following: arsenic, asbestos, beryllium, cadmium, chromium, coal smoke, diesel fumes, nickel, silica and soot.
5. Are there any drawbacks to being screened?
With any tests, there are always risks. The radiation exposure from these scans is low, however.
Sandler said that what her team discusses the most in terms of risks with any cancer screenings is the risk of “false positives.” With lung cancer screening, a positive screening exam (one that finds an abnormality) usually results in the more imaging, but sometimes it requires biopsies or surgeries where cancer may not be ultimately found.
The possibility of missing something is also a factor with all tests. Therefore, yearly screenings are very important for people who are at a higher risk for lung cancer. Getting checked every year lowers the chances that something will be overlooked for many years. Yearly screening can also detect small, early-stage cancers because they are found within a year of becoming visible on imaging. If your lungs are being monitored regularly, there is a much greater chance of catching a cancer early, when it is easiest to treat.
If you meet the criteria for lung screening, ask your primary care provider to refer you for lung screening. If you do not currently have a healthcare provider, Vanderbilt’s program can help you. For more information, see www.VanderbiltLungScreening.com or call 615-936-3606.
