Should I get a lung CT scan?
In 2013, the U.S. Preventive Services Task Force recommended annual lung cancer screening using low-dose computed tomography (CT) for adults aged 55 to 80 years who currently smoke or have a strong history of smoking (30 pack-years or have quit within the past 15 years). This recommendation first came into consideration after the National Cancer Institute (NCI) released the results of the National Lung Screening Trial (NLST) on August 4, 2011. This was a large-scale test of low-dose CT scans as a method for screening for lung cancer among patients at high risk for lung cancer.
The NLST was a randomized controlled trial that enrolled more than 53,000 current and former heavy smokers aged 55 to 74 and compared the effects on lung cancer mortality of two lung cancer screening procedures, low-dose helical computed tomography (CT) and standard chest X-ray. This study found 20 percent fewer lung cancer deaths among trial participants screened with low dose helical CT. The NLST was sponsored by NCI, a part of the National Institutes of Health, and conducted by the American College of Radiology Imaging Network (ACRIN) and the Lung Screening Study group. Additional details about these results can be found at the National Cancer Institute website. Details about the NLST trial can be found here.
The USPSTF recommends low-dose CT screening as a means to reduce the likelihood that an individual at high risk for lung cancer will die of lung cancer. However, individuals considering low-dose CT screening should understand the following points:
- Smoking cessation remains the most effective way of reducing the risk of developing lung cancer. The single best way to preventing lung cancer is to never start smoking.
- Medicare/Medicaid and most insurance companies currently do not cover the cost of low-dose CT screening. However, any follow-up care required after the exam will likely be covered by your insurance or Medicare/Medicaid.
- A low-dose CT scan has the potential for revealing abnormalities that are not caused by lung cancer and that you did not expect. These findings may require that you be subjected to additional diagnostic procedures (e.g. bronchoscopy, needle biopsies, surgery), which have their associated risks and costs.
- While low-dose CT scans tend to expose you to less radiation than normal CT scans, you will nevertheless be exposed to radiation, which can cause health problems.
The recommendations from the USPSTF apply to individuals considered at high risk for lung cancer according to the following criteria:
- Age 55 to 80 years and have quit within 15 years and
- Smoked 1 pack a day for 30 years OR
- Smoked 2 packs a day for 15 years
- Current cigarette smokers and former smokers who quit within 15 years
- A cigarette smoking history of at least 30 pack-years
If you do not meet these criteria, it is currently unknown whether you will benefit from a low-dose CT scan.
If you think you qualify for low-dose CT screening, you may call the Lung Cancer Early Detection and Prevention Clinic at (206) 288-6734 or have your doctor call us with a referral.