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Risks and Rewards of Lung Cancer Screening

Medically reviewed by Kelly Fan, MD, Susan Kerrigan, MD and Marianne Madsen on January 8, 2023

Plenty of things are worth waiting for. A lung cancer screening is not one of them. The sad truth is that by the time a patient shows symptoms, it may be too late. When lung cancer is detected early, success is far more certain. Although smoking rates have been declining for decades, a study last year suggested a recent drop in mortality rates from the most common form of lung cancer (non-small cell lung cancer) is due mainly to advances in treatment. Early detection is key.


So if you’re a smoker or former smoker over the age of 50, it’s a good idea to have regular screenings. New data suggests it may be a good idea even if you don’t fall into a high-risk category. So what’s involved, how risky is the radiation, and what are your options if your lung cancer screening detects signs of the disease?


Improving Odds 


Across the globe, lung cancer is the most common of all cancers for men. For women, it’s in the top three. In the United States, the United Kingdom, and many other Western countries, this type of cancer peaked decades ago. Today, Hungary tops the list with the highest rate of lung cancer worldwide, followed by Serbia. Researchers note that changing social norms and their effect on smoking patterns drive much of the shift. As countries industrialize and liberalize, women often begin smoking in greater numbers while relative wealth and education usually lead to increases in nonsmokers. Yet for developing nations, air pollution contributes a great deal to rising incidences of lung cancer


New treatments for non-small cell lung cancer (NSCLC) include immune checkpoint inhibitors to aid the immune system’s battle against cancer cells and treatments targeting genetic changes seen in common lung cancer tumors.  If you are over age 50 and smoked a pack a day for 20 years or 1 pack a day for 10 years, you need to schedule a lung cancer screening. While quitting smoking has immediate benefits, even if you haven’t puffed in a decade, you still need to get screened. So what’s involved?


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Lung Cancer - When Should I Get Screened?

Lung Cancer - When Should I Get Screened?

CT Scans


A CT (computed tomography) scan creates a collage of X-rays. Prized for its ability to detect abnormalities as single X-ray never could, CT scans have become very popular. There is some concern because CT scans can deliver 300 times more radiation than a single X-ray. Although CT scans may increase the possibility of developing fatal cancer to around one in 2,000, the risk of dying from cancer under normal circumstances is far higher. Lung cancer screenings are especially low risk because they use low-dose CT scans.


Before the low-dose CT scan, remove any metal. Make sure not to wear an underwire bra. You’ll lie down on a table within a donut-shaped ring while the person running the scan moves to another room. This technologist will ask you to lie very still and hold your breath. Inside the ring, a machine will spin around you shooting a burst of X-rays from multiple angles. Combined by a computer, the low-dose CT scan offers 3D pictures of your lungs. The procedure is over in less than one minute.


It’s an extremely valuable part of an oncologist’s arsenal not only for detecting cancer but for monitoring its recurrence. It’s also ideal for seeing if cancer has spread –– as it often does with lung cancer. CT scans are also used to determine the cancer’s stage of development. Afterward, you’ll meet with your doctor to discuss any abnormalities along with treatment options.  If nothing is detected, your doctor will probably advise you to return in a year.  Although smaller lung nodules can be non-cancerous (or scars from an infection), larger nodules and ones that are growing are far more likely to be cancerous. Your scan may even reveal other lung conditions like emphysema. The low-dose CT scan is less effective for people facing serious respiratory illness because it is less likely that treatment will be beneficial. Similarly, it is not generally recommended for those over the age of 80.


Besides smokers (both current and former), anyone with a family history of lung cancer should consider getting tested. Unfortunately, the percentage of people who have never smoked who get lung cancer is on the rise. In the U. S., for example, around 12% of lung cancer patients have never smoked. The World Cancer Research Fund International’s Continuous Update Project examines global data to determine how diet, nutrition, and physical activity affect cancer risk and survival. The panel favors being physically active and suggests that current smokers can decrease their lung cancer risk by eating plenty of fruits and vegetables. The panel also sees a link between eating red meat, taking high-dose beta-carotene supplements, or drinking water containing arsenic and an increased risk for lung cancer. Despite the evidence, healthy nonsmokers under the age of 50 are not currently advised to get regular lung cancer screenings.


Written by John Bankston

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