Health & Fitness

Who needs lung cancer screening?

Matthre Arneson
Matthre Arneson

Lung cancer is a certified killer, and it’s much more common than people realize. Of everyone who dies from cancer, more than a quarter will die from lung cancer. Lung cancer is the most common cancer in United States and worldwide.

About 90 percent of lung cancer cases are from smoking, and the five-year survival rate is pretty dismal. A little more than half survive past five years if their cancer hasn’t spread yet when found, but that drops to less than one in five if it has spread. Only about 15 percent of patients are diagnosed at an early stage. If we can find and treat it at the early stage, we can have a better cure rate.

While screenings exist for breast, colon, and other cancers, until 4 years ago there was no recommended reoccurring screening for patients at risk for lung cancer. Lung cancer screening patients who receive a low dose CT scan are 20 percent less likely to die from lung cancer than with standard screening chest X-rays.

Should I be screened? — You should get screened if you’re between the ages of 55 and 80, a current smoker or quit smoking within the last 15 years, and have a 30 pack-year smoking history. (Pack-years are packs per day times the number of years you smoked. So, if you’ve smoked one pack a day for 30 years, or two packs a day for 15 years, you fit the criteria.) Studies show that you’re still at increased risk for lung cancer even 15 years after you’ve quit smoking.

A low-dose CT scan is the only reliable screening method. With a chest X-ray, you often can’t see nodules that are close to the heart or other organs. Some nodules are very small and the X-ray is not as sensitive in finding small nodules. The smaller the nodule, the more likely it is to be cured.

Risks and benefits — The benefits of lung cancer screening are clear. You’re more likely to have small nodules detected so you can start the treatment process earlier than if you wait for symptoms. The goal of screening is to detect disease at a stage when it is not causing symptoms and when treatment is most successful. Symptoms of lung cancer include coughing up blood, pain, shortness of breath and weight loss. Unfortunately, when symptoms arise, it often means the cancer has advanced. A low dose CT scan for lung cancer screening is not covered by insurance if any of these symptoms are present and you should talk to your doctor as soon as possible about your symptoms.

The risks of a screening are few. It’s called a low-dose CT scan for a reason, which correlates to the very low amount of radiation you’re exposed to. While the dose of the radiation is less than you’d receive just walking around for a year, it’s still something. Some studies suggest that starting screenings before age 50 can cause more cases of radiation-induced lung cancer.

The other downside is the risk of a false positive, which refers to when something shows up on a scan and requires further tests, but turns out not to be cancer. About 15 – 30 percent of nodules suspicious of cancer on lung screening CT are found to be non-cancerous.

Remember, no test is 100 percent accurate and before anyone gets a CT scan, there should be a conversation about risks and options, as well as the risks of false positives and negatives.

Talk to your doctor if you’re a current or former smoker between the ages of 55 and 80 to see if a screening is right for you.

Wesley Healthcare developed the first lung cancer screening program in Wichita and is the only program with fellowship trained thoracic radiologist and surgery specialist on the team.

Matthew Arneson, MD, is a cardiothoracic surgeon with Wichita Surgical Specialists. For more information about lung cancer screening or to schedule an appointment, please call 316.962.5864.