Update: On March 9, 2021, the US Preventive Services Task Force (USPSTF) issued new recommendations to expand screening for lung cancer in people who have a history of smoking but no symptoms of the disease. Under the new guidelines, screening is recommended to begin five years earlier.
The USPSTF now recommends yearly low-dose computed tomography (CT) scans for people between the ages of 50 and 80 who are at high risk for lung cancer because of their smoking history.
The group also changed its definition of what is considered high risk, lowering it from 30 pack years to 20. (A “pack year” is based on how many years you smoked an average of one pack of cigarettes per day — or the equivalent. For example, 20 pack years means you smoked one pack a day for 20 years or two packs a day for ten years.)
In releasing the updated guidelines, the USPSTF noted that the new recommendations mean more Black people and women will be eligible for lung cancer screening because they tend to smoke less heavily. Memorial Sloan Kettering experts support the new guidelines, which may detect more cases of lung cancer at an early stage when it is more likely to be curable.
Despite advances in treatment, lung cancer remains the leading cause of cancer deaths. However, many lung cancer-related deaths are potentially preventable through lifestyle changes and earlier detection.
Far and away, the most effective way to prevent the disease is to not smoke. Quitting can be very hard, though, as many people have smoked heavily for decades. Fortunately for this group, there is a proven way to reduce lung cancer deaths. In recent years, low-dose CT scanning has proven to be a powerful tool for detecting lung cancer at an early stage when it can usually be successfully treated.
Memorial Sloan Kettering thoracic surgeon and lung cancer specialist Bernard Park explains who should get this type of screening and how it works.
How do I know if I should get screened for lung cancer?
At MSK, we follow the current screening guidelines of the US Preventive Services Task Force when recommending a CT scan to detect lung cancer. You are eligible if you are between the ages of 55 and 80 and are either a current smoker or a former smoker who quit within the past 15 years. You are considered high risk if you smoked an average of one pack of cigarettes per day for at least 30 years or the equivalent — for example, two packs a day for 15 years.
MSK offers an online quiz to help current and former smokers determine if they are eligible for screening. This quiz asks a few questions about your age and smoking history, and it takes about two minutes to complete. If you learn that you are eligible for screening, it is easy to call and make an appointment or schedule one online.Back to top
If screening is recommended for me, what does that mean?
If you are eligible and wish to undergo screening, you will need to answer a few brief questions from a licensed independent practitioner (physician, nurse practitioner, or physician assistant) to confirm your eligibility. They can answer any questions you have about the risks and benefits of the test.
You will then undergo a low-dose CT scan, which combines special x-ray equipment with computers to take multiple pictures of the inside of the body. These scans are quick and painless, don’t require any type of contrast dye to be injected, and can be done the same day as the eligibility visit. The scanner is open on both ends, and you pass through it on a bed. The actual procedure takes less than five minutes. At MSK, we work to ensure we are delivering the lowest radiation dose possible while still getting highly accurate scans.Back to top
How can low-dose CT scanning reduce my risk of dying from lung cancer?
Studies have shown that screening with low-dose CT scans, usually once a year, can reduce deaths by detecting the cancer early enough that treatments are effective. Of those who are diagnosed through screening, the overwhelming majority — around 85% to 90% — have stage I disease. People tend to think of lung cancer as fatal because it causes so many deaths, but with treatment at this early stage — usually surgery or radiation — it is curable up to 90% of the time. Early-stage lung cancer almost never causes symptoms, so usually the only way to diagnose it is through a scan.
What else should people know about this type of lung cancer screening?
For something that is so effective at detecting lung cancer early, low-dose CT scanning is still not used widely in people who would benefit. One potential reason is the stigma that is still associated with lung cancer — that it’s a disease of people who smoke and that people brought it on themselves. Many people are uncomfortable thinking they may be at risk and downplay how much they have smoked. They also are afraid that a lung cancer diagnosis means death.
It is important to take the stigma away and encourage people that regardless of how much they smoked, there’s an effective way of catching lung cancer early enough to be cured. Most insurers will cover lung screening in eligible patients.
In addition to getting screened for lung cancer, people in this high-risk group should know that quitting smoking is one of the most important things anyone can do to improve their health. Moreover, there are many resources available to help with this difficult but important preventive measure. MSK offers a Tobacco Treatment Program that is open to everyone, regardless of whether they had cancer.Back to top