Lung Cancer Screening Frequently Asked Questions
Yearly lung screening with low-dose CT (LDCT) has been shown to save lives by finding lung cancer early, when it is easier to treat. This handout answers many questions that people have about LDCT lung screening. If you have additional questions, please call talk to your physician.
What is the goal of LDCT lung screening?
The goal of LDCT lung screening is to save lives by diagnosing lung cancer earlier. Without LDCT lung screening, lung cancer is usually not found until a person develops symptoms. At that time, the cancer is much harder to treat.
Who should get an LDCT lung screening exam?
The Premier Health Cancer Institute physicians decided to use the National Comprehensive Cancer Network’s (NCCN) guidelines. This decision was made to be consistent with national guidelines for LDCT screenings. LDCT lung screening is recommended for the following groups of people who are at high risk for lung cancer. Those who have symptoms of a lung condition at the time of screening, such as a new cough or shortness of breath, are not eligible.
- Group 1: People ages 55−74 who have smoked at least an average of 1 pack a day for 30 years. This includes people who still smoke or have quit within the past 15 years.
- Group 2: People ages 50−74 who currently or in the past have smoked at least an average of 1 pack a day for 20 years.
They must also have at least 1 other risk factor for lung cancer, not including exposure to secondhand smoke. Risk factors for lung cancer include having cancer in the past, emphysema, pulmonary fibrosis, a family history of lungcancer and exposure to certain substances (including asbestos, arsenic, beryllium, cadmium, chromium, diesel fumes, nickel, radon, silica and uranium). Your healthcare provider can help you determine if you have one of these other risk factors.
Why does it matter if I have symptoms?
Certain symptoms can be a sign that you have a condition in your lungs that should be evaluated and treated, if necessary, by your healthcare provider. These symptoms include fever, chest pain, a new or changing cough, shortness of breath that you have never felt before, coughing up blood, or unexplained weight loss. Having any of these symptoms can greatly affect the results of lung screening and may actually delay the treatment you might need.
I am in one of the high-risk groups but have been diagnosed with cancer in the past. Is LDCT lung screening appropriate for me?
In some cases, LDCT lung screening will not be appropriate, such as when your doctor is already following your cancer with CT scan studies. Your doctor will help determine if LDCT lung screening is right for you.
Why don’t lung cancer screenings cover people impacted by second-hand smoke?
At this point in time lung cancer screenings are recommended only for people at high risk of lung cancer. The criteria being used for the screening is based on the NCCN guidelines. While second-hand smoke is a risk factor for lung cancer, exposure to it – even over an extended period of time – does not put someone into a high risk group that qualifies for a LDCT lung cancer screening. Therefore, lung cancer screenings are not currently recommended for people who have only been exposed to second-hand smoke.
If a patient doesn’t qualify for the screening, can their doctor order a test for them?
Medical testing is performed on an as needed basis based on certain criteria. It would be up to the patient’s doctor to determine if other tests are warranted. We cannot perform a LDCT screening on anyone who does not meet the NCCN criteria.
Do I need to have an LDCT lung screening exam every year?
Yes. If you are in one of the high-risk groups described on page 1, a LDCT lung screening exam is recommended every year until you are 74.
How effective is LDCT lung screening at preventing death from lung cancer?
Studies have shown that LDCT lung screening can lower the risk of death from lung cancer by 20% in people who are at high risk.
How is the exam performed?
LDCT lung screening is one of the easiest screening exams you can have. The exam takes less than a minute. No medications are given, and no needles are used. You can eat before and after the exam. You do not even need to get changed as long as the clothing on your chest does not contain metal. You must, however, be able to hold your breath for at least 6 seconds while the chest scan is being taken.
Are there any risks to LDCT lung screening?
There are several risks and limitations of LDCT lung screening. We want to make sure that we have done a good job explaining these to you, so please let us know if you have any questions. Your healthcare provider who ordered the screening may want to talk with you more about this:
- Radiation exposure: LDCT lung screening uses radiation to create images of your lung. Radiation can increase a person’s risk of cancer. By using special techniques, the amount of radiation in LDCT lung screening is small—about the same amount a person would receive from a screening mammogram. Further, your doctor has determined that the benefits of the screening outweigh the risks of being exposed to the small amount of radiation from this exam.
- False negatives: No test, including LDCT lung screening, is perfect. It is possible that you may have a medical condition, including lung cancer, that is not found during your exam. This is called a false negative.
- False positives/additional testing: LDCT lung screening very often finds something in the lung that could be cancer but in fact is not. This is called a false positive. False positive tests often cause anxiety. In order to make sure these findings are not cancer, you may need to have more tests. These tests will be performed only if you give us permission.
Occasionally, patients need a procedure, such as a biopsy, that can have potential side effects. For more information on false positives, see “What can I expect from the results?”
- Findings not related to lung cancer: Your LDCT lung screening exam also captures images of areas of your body next to your lungs. In a small percentage of cases (5%−10%), the CT scan will show an abnormal finding in one of these areas, such as your kidneys, adrenal glands, liver or thyroid. This finding may not be serious; however, you may need to be examined further. Your healthcare provider who ordered your exam can help determine what, if any, additional testing you may need.
How much does the screening cost?
Premier Health is offering lung cancer screenings at the self-pay rate of $79. This screening is not covered by insurance but may be reimbursable through a flexible spending account. Please check with your benefits provider to learn more.
Since these are self-pay screenings, why can’t anyone have this exam even if they don’t meet the criteria?
Premier Health is following screening criteria established by the NCCN (National Comprehensive Cancer Network). According to the NCCN, “research has shown that screening reduces death from lung cancer among people at high risk. Limiting screening to those at high risk also helps people at lower risk avoid the dangers of screening.”1
What can I expect from the results?
About 1 out of 4 LDCT lung screening exams will find something in the lung that may require additional imaging or evaluation. Most of the time these findings are lung nodules.
Lung nodules are very small collections of tissue in the lung. These nodules are very common, and the vast majority—more than 97%—are not cancer (benign). Most are normal lymph nodes or small areas of scarring from past infections.
Less commonly, lung nodules are cancer. If a small lung nodule is found to be cancer, earlier detection has higher survival rates. That is why we are screening you.
To distinguish the large number of benign (noncancerous) nodules from the few nodules that are in fact cancer, we may need to get more images before your next yearly screening exam. If the nodule has suspicious features (for example, it is large, has an odd shape or grows over time), we will refer you to a specialist for further testing.
When will I get the results?
You will receive a letter containing the results of your exam within 2 weeks. If you do not hear from us within 2 weeks, please contact your physician.
Who else will receive the results?
Copies of your results will be shared with the healthcare provider who ordered your exam and one of Premier Health’s Lung Cancer Coordinators.
Where can I find help to quit smoking?
The best way to prevent lung cancer is to stop smoking. For help on quitting smoking, please call Premier Community Health at (937) 227-9440. If you have already quit smoking, congratulations and keep it up!
I think I qualify for LDCT lung screening. What should I do next?
Talk to your doctor to see if you qualify and to schedule your exam. Please note that we will need an order for LDCT lung screening from your healthcare provider before your exam.