What is Lung Cancer?

Lung cancer is an abnormal growth of lung tissue and is the leading cause of cancer death. Smoking and advanced age are the leading risk factors for lung cancer. Smoking is estimated to be responsible for 90% of all lung cancer cases. Symptoms of lung cancer include a cough, sometimes with bloody mucus, shortness of breath, and chest pain. Some people have no symptoms, especially in the early stages.

Early detection of lung cancer is important because surgical removal of part of the lung can be curative in the early stages. Other treatments for lung cancer include chemotherapy, radiation therapy, and immunotherapy. The best way to prevent lung cancer is to not smoke or to quit smoking.

Lung Cancer Screening

Lung cancer screening involves testing for a disease in the absence of symptoms or a history of the disease. Doctors recommend screening to find a disease at an early stage, when treatment may be more effective.

The only recommended screening test for lung cancer is low-dose computed tomography (also called low-dose CT scan or LDCT). During an LDCT, you lie on a table and an X-ray machine uses a low dose (amount) of radiation to take detailed images of your lungs. The exam only takes a few minutes and is painless.

Possible Signs and Symptoms of Lung Cancer

• A new cough that doesn't go away or gets worse;
• Chest pain that often gets worse when you take a deep breath, cough, or laugh;
• Hoarseness;
• Unexplained weight loss and loss of appetite;
• Coughing up blood, sputum, or rust-colored mucus;
• Shortness of breath;
• Infections such as bronchitis and pneumonia that don't go away or keep coming back;
• Wheezing;

Many patients with lung cancer do not have any symptoms at the beginning of the disease. It is best to detect lung cancer at an early stage, before symptoms appear, as the cancer is then easier to treat. This is why screening is important.

If you experience any signs or symptoms of lung cancer, remember to speak with your healthcare professional.

Who Should Get Lung Cancer Screening?

Annual lung cancer screening with LDCT is recommended for people who:

• Have a 20 pack-year or more smoking history, and
• Currently smoke or have quit smoking within the past 15 years, and
• Are between 50 and 80 years old;

A pack-year is defined as 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 per day for 20 years or two packs per day for 10 years.

Risks of Screening

There are at least three risks to lung cancer screening.

A lung cancer screening test may suggest that a person has lung cancer when they do not. This is called a false-positive result. False-positive results can lead to unnecessary follow-up tests and surgeries that carry further risks.

A lung cancer screening test may find cancers that may never have caused the patient any problems. This is called overdiagnosis. Overdiagnosis can lead to unnecessary treatment.

Radiation from repeated LDCT tests can cause cancer in otherwise healthy people.

Therefore, lung cancer screening is only recommended for adults who have a high risk of developing the disease due to their smoking history and age and who don't have a health problem significantly limiting their life expectancy or their ability or willingness to undergo lung surgery, if needed.

If you are considering getting screened, talk to your doctor. If lung cancer screening is right for you, your doctor can refer you to a quality screening center.

The best way to reduce your risk of lung cancer is to not smoke and avoid secondhand smoke. Lung cancer screening is not a substitute for quitting smoking.

 

When Should Screening Stop?

It would be best to stop annual lung cancer screening when the screened person

• Reaches age 81, or
• Has not smoked for 15 years or more, or
• Develops a health problem that makes them unwilling or unable to have surgery for lung cancer;

What is the Difference Between Screening and Diagnostic Testing?

Screening is a medical term for tests intended to find a disease before it causes symptoms or problems. Lung cancer screening is done to find lung cancer before it has spread.

Diagnostic testing is not the same as screening. Diagnostic tests are done when a person has signs or symptoms of lung cancer or when a screening test finds something that looks like cancer. In both cases, the probability that the person has lung cancer is higher, and further tests are done to obtain a definitive diagnosis. It differs from screening because it may involve high-dose radiation scans, other tests to examine the lungs, and taking samples of lung tissue.