Should I get a lung CT scan?

On November 4, 2010, the National Cancer Institute (NCI) released the interim results of the National Lung Screening Trial (NLST), 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 National Lung Screening Trial (NLST), a randomized controlled trial that enrolled more than 53,000 current and former heavy smokers ages 55 to 74 to compared the effects of two screening procedures for lung cancer, low-dose helical computed tomography (CT) and standard chest X-ray, on lung cancer mortality. 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.

These results suggest that low dose CT screening can 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:

1. 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.
2. The current estimated Medicare reimbursement rate for a CT scan of the lung is $300, but this varies by geographic location. Insurance reimbursement rates also vary. This may not cover the entire cost of the CT scan.
3. 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.
4. 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.
5. The findings of the above study apply to individuals at high risk for lung cancer who have met all of the criteria below:
   1. Age 55 to 74 years
   2. Current cigarette smokers and former smokers who quit within 15 years
   3. 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 are interested in a low dose CT of your lungs, please contact our Lung Cancer Early Detection and Prevention Clinic at 206-288-6723.