Lung Cancer Screening

Recent results from the National Lung Screening Trial (NLST) show that computerized tomography (CT or CAT scan) can detect lung cancer at an early stage and reduce your risk of dying from the disease. The NLST compared low dose CT scanning of the lungs with chest X-rays in people at risk for lung cancer (men and women age 55 to 75, who smoked an equivalent of a pack of cigarettes a day for 30 years).

The study results demonstrate a 20% reduction in lung cancer deaths among those screened yearly with CT scans. These encouraging results support the value of screening with low dose CT for a select population of current and former smokers.

Lung cancer screening with CT is not yet a standard recommendation. National agencies that develop screening guidelines are still working on their recommendations, which will affect whether Medicare and private insurance companies cover lung screenings in the future, how often and for whom.

Who should be screened for lung cancer?

People who are eligible for lung cancer screening:

  • Are 55-74 years of age
  • Are current smokers, or former smokers who have quit within the past 15 years
  • Have a smoking history of 30 packs/year or greater
  • Must have an order from their primary physician

Current evidence does not support screening people who have not been heavy smokers or who have only been exposed to second-hand smoke.

Screening everyone may cause more harm than good because lung cancer screening has certain risks. For example, doctors find a lung nodule suspicious for lung cancer in about 25% of patients who get a screening CT scan. All of these abnormalities require further testing to determine if they are cancer, but only a few (less than 4%) are actually lung cancer.