Lung Cancer Screening: What Is It & What to Expect

There are a lot of important things to know about lung cancer, but one of the most important may be what you’ll read right here about lung cancer screenings. Lung cancer screenings are important to know about because the key to positive outcomes in lung cancer treatment is early detection and diagnosis.

One of the reasons that lung cancer is the leading cause of cancer death in the U.S. for both men and women is because often symptoms do not show until it’s already in an advanced stage lung cancer. A lung cancer screening test aims to change this, finding the disease at an early stage when treatment is more effective.

What Is a Lung Cancer Screening?

The only proven test for lung cancer screenings is low-dose computed tomography (LDCT).

During this low-dose CT scan, a specific type of X-ray machine scans your body and uses a low dose of radiation to create high-quality images of your lungs and lung tissue. Clinical trials have shown that among heavy smokers, LDCT can reduce the risk of losing their lives to lung cancer, potentially increasing their life expectancy.

But because this type of screening can detect lung abnormalities that are not cancer and may prompt additional testing or procedures, yearly lung cancer screening is typically only recommended for those at a high risk of lung cancer, which is people ages 50 to 80 with a 20-plus pack-year history of tobacco use.

If your health professional recommends a lung cancer screening, they will discuss the pros and cons with you, and help you understand what to expect before, during and after the screening.

To help you feel prepared and empowered, here’s a quick look at what the test entails.

Who Should Have a Lung Cancer Screening?

Lung cancer is generally seen in older adults 65 years of age and older.

According to the American Lung Association, about 90% of lung cancer diagnoses are attributable to active smoking.

For this reason, the U.S. Preventive Services Task Force (USPSTF) recommends:

• a lung cancer screening age range of 50 and 80 years
• AND people who have a 20 pack-year or more smoking history
• AND people who are current smokers or have quit smoking within the past 15 years for an annual LDCT screening.

Smoking cessation can help to considerably lower your lung cancer risk. Past research shows that quitting tobacco smoking before the age of 50 can lower your cancer risk by 57%.

It’s important to remember that you can still develop lung cancer even if you have never smoked your entire life.

People with a family history of lung cancer and certain genetics — including gene changes and inherited gene mutations — may also be at a high risk for lung cancer.

Those who have long-term exposure to secondhand smoke, diesel exhaust, radon, asbestos and other chemicals, as well as air pollution, may also be at an increased risk of developing lung cancer, such as construction workers, factory workers, farmers, miners, and those who work in the petroleum industry.

And past studies show that there are also some ethnic differences in lung cancer rates. For example, African-Americans have the highest rate of lung cancer diagnoses, while those of Latin descent have the lowest.

Based on your medical history and lung cancer risk factors, your AdventHealth health care provider will advise if you should receive a lung screening at an earlier age or not.

Is an LDCT The Most Effective Lung Cancer Screening Option?

According to the American Cancer Society, the LDCT scan is the best option for people who are at a high risk for lung cancer, such as former smokers. These types of scans are able to locate unusual areas in the lungs — including very small spots — which can then be examined further to determine whether it is cancer or not.

LDCT scans are different from standard chest x-rays, which are not recommended for lung cancer screening due to their low sensitivity in detecting cancerous areas.

A study of more than 15,000 people who received LDCT screenings published in January 2020 in The New England Journal of Medicine found that lung cancer deaths lowered by 33% for women and 24% for men over a 10-year follow-up period.

Other benefits of the LDCT scan is its speed, noninvasive nature and small radiation exposure.

Should Lung Cancer Screenings Be Done at Certain Intervals?

In addition to the recommended lung cancer screening age range and pack-years, the USPSTF also suggests this group receive an LDCT screening every year.

It’s important to remember that while an LDCT screening test can’t stop you from getting cancer, early detection can greatly improve your chances of treating the disease and stopping its growth and spread.

Thankfully, Medicare and most health insurance plans will cover lung cancer screenings if you meet their specific eligibility criteria. Make sure to call your provider and review your plan to see if you will be responsible for any co-pays or deductibles for LDCT screenings.

What Are the Risks of Lung Cancer Screening?

Because the LCDT scan is noninvasive, the risks for this type of screening are very minimal and include:

• false positive or negative
• overdiagnosis
• anxiety or stress before the screening
• potential radiation exposure found in any type of CT screening

When Should Screenings Stop?

The USPSTF recommends that an annual lung cancer screening program should halt when a person:

• is 81 years old
• has not smoked for at least 15 years
• develops a health problem where they would not be able to have surgery if lung cancer was spotted

Safety Measures to Expect

If you’re concerned about seeking out a diagnosis or treatment today, please know that we are taking precautionary measures to protect your health and safety. These include:

• Enforcing a strict visitor’s policy
• Practicing social distancing by keeping patients at least six feet apart
• Taking temperatures of everyone who enters our facilities
• Treating patients with COVID-19 symptoms in separate areas
• Wearing protective masks

What to Expect Before the Screening

Unlike some other health care scans, an LDCT scan does not require any special preparations like fasting or eating/drinking certain foods. This type of screening also does not need contrast dyes or anything else that may be administered with an injection or needle.

In most cases you can wear your normal clothes for the scan, unless they contain any metal.

Metal can affect the quality of an image on LDCT scans. Before your scan, you’ll be asked to remove metal objects, such as jewelry, hairpins, eyeglasses and removable dental work.

And as with any health-related procedure, always make sure to alert your doctor if you are pregnant or are taking any medications that might interfere with the scan.

What to Expect During the LDCT Scan

LDCT is a painless, noninvasive imaging test. In the test, an X-ray machine scans your body in a spiral path. This machine is linked to a computer, which processes the scanned information and creates a series of detailed images. The amount of radiation to which you’re exposed is up to 90 percent less than with a conventional CT scan of the chest.

The machine used for LDCT typically looks like a large box with a short tunnel in the middle. You’ll lie on a table that slides in and out of this tunnel. A radiologist will help you get into the right position on the table — usually lying flat on your back.

Once you’re in position, the table slides through the tunnel quickly to find a starting point for the scan. Then the table slides through a second time as the scan is performed. During this scanning process, any motion— even breathing —could blur the image. You’ll need to hold your breath for five to 10 seconds.

What to Expect After a Lung Cancer Screening

About one in four LDCT screenings find abnormal areas in or near the lungs, such as lung nodules. Most turn out to be something other than cancer, such as scarring from a past infection. To know for sure and bring you peace of mind, however, you may need follow-up testing.

If this happens, you’ll be asked to come back for another LDCT scan in several months. By comparing the two scans, your doctor can see whether the abnormal area is growing. If it is, your doctor may recommend further evaluation. You might need to get additional imaging or a biopsy (removal of tissue for analysis in the lab).

Learn More About AdventHealth’s Lung Cancer Screening Program

Whatever your health journey brings, it’s important to find a care partner on your path to whole health. With a focus on prevention, our experts can guide you with recommendations on keeping your lungs healthy or determine if a lung cancer screening is right for you.

If you think you might be at risk for lung cancer and want to learn more about the potential symptoms of lung cancer, come to our experts for health care guidance and support. With leading-edge imaging technology, lung cancer specialists and a mission to heal body, mind and spirit, our whole-person cancer care is second to none.