Health library

Lung cancer screening

Is it right for you?

If you've ever been a smoker—or spent a lot of time around secondhand smoke—you might wonder if you should be screened for lung cancer. Low-dose CT scans can detect lung cancer early, before symptoms appear. But screening isn't for everybody. This tool is designed to help you decide whether lung cancer screening is appropriate for you.

Are you age 50 to 80 with a history of heavy smoking?

If you answered "yes." Two of the criteria for lung cancer screening are being age 50 to 80* and having a history of heavy smoking. Heavy smoking is defined as a smoking history of 20 "pack years" or more. A "pack year" is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20-pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

*If you're on Medicare, the covered age range is 50 to 77 years old.

If you answered "no." Two of the criteria for lung cancer screening are being age 50 to 80* and having a history of heavy smoking. Heavy smoking is defined as a smoking history of 20 "pack years" or more. A "pack year" is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20-pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

If you don't have a history of heavy smoking, lung cancer screening may not be recommended.

*If you're on Medicare, the covered age range is 50 to 77 years old.

Are you a current smoker or did you smoke in the past?

If you answered "yes." Quitting smoking is even better than screening for reducing your risk of lung cancer. But if you still smoke or have a history of smoking, screening may be recommended.

If you answered "no." Quitting smoking is even better than screening for reducing your risk of lung cancer. If you never smoked, lung cancer screening may not be recommended.

Have you discussed the benefits of screening with your doctor?

If you answered "yes." Great. But just to recap, if you are screened for lung cancer, you may have a decreased chance of dying from lung cancer.

People with the highest risk are the most likely to benefit from screening. For example, people who smoke more than one pack a day have a higher risk for lung cancer than people who quit 10 years ago.

If you answered "no." If you are screened for lung cancer, you may have a decreased chance of dying from lung cancer.

People with the highest risk are the most likely to benefit from screening. For example, people who smoke more than one pack a day have a higher risk for lung cancer than people who quit 10 years ago.

Are you aware of the potential harms of screening?

If you answered "yes." OK. But just to make sure, harms include false alarms and additional testing that may turn out to have been unnecessary. A false alarm occurs when a person has a positive screening test but doesn't actually have lung cancer. That can lead to other tests, such as a biopsy, which involves removing a small bit of lung tissue to test it for signs of cancer. An invasive procedure like a biopsy can have complications, such as a collapsed lung or an infection.

The risks of invasive procedures like biopsies may be greater if you have medical problems caused by heavy or long-term smoking.

If you answered "no." Potential harms include false alarms and additional testing that may turn out to have been unnecessary. A false alarm occurs when a person has a positive screening test but doesn't actually have lung cancer. That can lead to other tests, such as a biopsy, which involves removing a small bit of lung tissue to test it for signs of cancer. An invasive procedure like a biopsy can have complications, such as a collapsed lung or an infection.

The risks of invasive procedures like biopsies may be greater if you have medical problems caused by heavy or long-term smoking.

Are you willing and healthy enough to have surgery if lung cancer is detected?

If you answered "yes." OK. Lung cancer screening is not recommended for people who are not willing or able to undergo surgery to treat their lung cancer.

If you answered "no." Lung cancer screening is not recommended for people who are not willing or able to undergo surgery to treat their lung cancer. That's because the benefits would not be worth the risks of the screening.

Do you have any symptoms of lung cancer?

If you answered "yes." Signs and symptoms of lung cancer include:

• A cough that doesn't go away or gets worse.
• Chest pain that is often worse when you breathe deeply, cough or laugh.
• A hoarse voice.
• Unexplained weight loss and loss of appetite.
• Coughing up blood or rust-colored spit or phlegm.
• Shortness of breath.
• Infections like bronchitis and pneumonia that won't go away or keep returning.
• Wheezing.

If you have any of the above symptoms, talk to your doctor as soon as possible. Screening tests are meant to detect signs and symptoms of cancer before they become apparent.

If you answered "no." That's good. Screening tests are meant to detect signs and symptoms of cancer before they become apparent. But just to review, possible signs and symptoms of lung cancer include:

• A cough that doesn't go away or gets worse.
• Chest pain that is often worse when you breathe deeply, cough or laugh.
• A hoarse voice.
• Unexplained weight loss and loss of appetite.
• Coughing up blood or rust-colored spit or phlegm.
• Shortness of breath.
• Infections like bronchitis and pneumonia that won't go away or keep returning.
• Wheezing.

If you have any of the above symptoms, you should call your doctor's office as soon as possible.

Results

Talk with your doctor about your results, and be sure to ask any questions that came up in this assessment. Together, you can decide what the right next step is for you.