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Published on November 14, 2022

Lung Cancer Screening for SmokersIllustration of People Smoking

Lung cancer is the leading cause of cancer death in both men and women in the United States. A lung cancer screening exam can help to identify cancer before any symptoms occur when the cancer is easier to treat. If you smoke, here’s how to determine if you should get screened for lung cancer every year.

“Smoking is by far the biggest risk factor for developing lung cancer,” says Daniel Saket MD, PIH Health diagnostic radiologist. “That’s why recommendations for lung cancer screenings focus only on people who currently smoke or have recently quit and have a history of smoking over many years.”

Depending on how long and how much you smoked, it may be recommended that you get an annual lung cancer screening.

What type of lung cancer screenings are available?

The only recommended screening test for lung cancer is a low-dose computed tomography (CT scan). This test is approved for patients who have a high-risk of developing lung cancer. The screening exam only takes a few minutes to complete and is painless. During the screening, you lie flat on a table and an x-ray machine uses a low dose of radiation to create a detailed image of your lungs. This allows medical professionals to see if there are any changes to your lungs that may indicate you have lung cancer.

Who should get a low-dose CT scan?

The current guidelines recommend that you get a low-dose CT scan every year if you meet the follow conditions:

  • You are between ages 50 and 80
  • You have smoked the equivalent of a pack a day for over 20 years
  • You currently smoke or have quit in the last 15 years

To determine your pack-year smoking history, multiply the number of packs of cigarettes you smoked per day by the number of years you have smoked. For example, if you smoked one pack a day for 20 years, you have a 20 pack-year smoking history (1 x 20 = 20). If you smoked two packs a day for 10 years, you also have a 20 pack-year smoking history (2 x 10 = 20).

It is recommended that screenings be stopped once you have not smoked for 15 years. If you develop a health problem that severely limits your life expectancy, or if you are unwilling or unable to have surgery if the screening uncovers possible cancer, screenings are also not recommended.

These guidelines are from the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP) and the American College of Chest Physicians. The American Cancer Society® also supports these recommendations.

Are there risks associated with lung cancer screenings?

The screening itself is quick, easy and painless, but as with all medical procedures, there are some inherent risks. That’s why lung cancer screening is only recommended for people who are at high risk of developing lung cancer due to their smoking history and age. The risks of screening include:

  • False positive results. The screening may suggest that a person has lung cancer when they don’t. This can lead to unnecessary follow-up tests, surgeries and emotional distress.
  • Over diagnosis. The screening may find cases of cancer that may have never caused a problem. This can lead to unnecessary treatment.
  • Radiation exposure. Although the screening uses a low dose of radiation, the radiation from repeated screenings causes a slight increase in cancer risk.

“If you smoke or have recently quit smoking, talk to your doctor about whether a low-dose CT scan is right for you,” says Dr. Saket.

The PIH Health Lung Cancer Screening Program is a Lung Cancer Alliance Screening Center of Excellence and is an American College of Radiology Lung Cancer Screening Center Designated Lung Cancer Screening Center. To learn more or to request a lung screening appointment, please visit PIHHealth.org/Lung or call 562.967.2892.

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