The new guidelines for lung cancer screenings encourage those at risk to get a low-dose CT scan. Who's at risk and why do they need a low-dose CT scan? We asked diagnostic radiologist, Kenyon Kopecky, M.D., FACR, at Irvington Radiology, to weigh in.
Who is really at risk for lung cancer?
Smokers are at the highest level of risk. The United States Preventive Services Task Force recommends annual screening for lung cancer for adults ages 55 to 80 years who have a 30 pack-year smoking history (one pack per day for 30 years or two packs per day for 15 years) and currently smoke, OR adults in the same age range who have quit within the past 15 years.
For a smoker who is otherwise healthy, scheduling a lung screening may not seem urgent or even necessary. In fact, the idea of screening individuals at “high risk” has been debated for decades. But, simply put, smoking is the biggest risk factor in all cancer types. Smoking causes 90 percent of all lung cancer cases.
How are physicians striving to catch lung cancer early?
Catching lung cancer early is challenging because many patients may not have any noticeable symptoms. Almost 40 percent of adults are diagnosed with advanced lung cancer because it is not caught early enough. While lung cancer starts in the lungs, this cancer type can spread to other parts of the body, including the bones, liver, and brain. The goal is to find lung cancer when it is in a treatable stage. Utilizing the low-dose CT scan helps physicians do that by improving early detection rates.
What is a low-dose CT scan?
It is a low-dose computed tomography scan. A high-speed CT scanner is used to capture high-resolution images of the lungs with limited ionizing radiation. A radiation oncologist will then review the images of the lung for any abnormalities. The examination is simple, safe and painless (no needles) and there are no diet restrictions. The scan itself takes less than one minute.
Are low-dose CT scans dangerous?
The National Lung Screening Trial (NEJM 2011) studied people aged 55 years to 74 years who had smoked at least one pack of cigarettes per day for 30 years or more. Heavy smokers who had quit smoking within the past 15 years were also studied. The trial used chest X-rays and low-dose CT scans to check for signs of lung cancer.
The low dose CT scans were better than chest X-rays at identifying early-stage lung cancer. The National Lung Screening Trial showed that three lung cancer deaths were prevented for every 1,000 people who received CT screening. Screening at-risk adults with low-dose CT reduces lung cancer mortality by 20 percent and all-cause mortality by 6.7 percent.
In contrast, screening with chest X-rays or sputum cytology (examining coughed up phlegm for cancer cells) does not decrease the risk of dying from lung cancer. The low dose CT used to look for lung cancer is a low-dose form of X-ray, delivering about the same radiation as a mammogram.
Is a spot on the lung always cancer?
Some spots or nodules in the lungs are cancer; however, most are not. Many people have lung nodules which are not cancerous. Most noncancerous lung nodules are the result of previous infection. In Indiana, the most common infection that causes lung nodules is a fungus called histoplasmosis. But a low dose CT scan cannot distinguish between cancerous and noncancerous nodules, often creating a spot on the lung scan. If many spots appear and the patient is at high risk for cancer, we'll perform additional tests, including biopsy in some cases.
Does the lung screening involve special prep?
There is no prep, and there are no needle punctures. The low-dose CT lung scan appointment takes no more than 30 minutes. The scan itself takes only a few seconds.
I think I am a candidate for lung screening. What should I do?
First, talk to your physician. Here are some questions to get that conversation started:
- What is my risk of lung cancer?
- Can you help me calculate my pack years for my smoking history?
- If I still smoke, how can you help me quit? Do you recommend I receive a low dose CT scan to screen for lung cancer?
Lung screenings at CommunityCommunity Health Network offers lung screening at imaging centers and its hospitals seven days a week. You can even schedule a screening online and up to two hours in advance. Prefer calling to make an appointment? No problem. Call scheduling today at 317-355-4680.