Why lung cancer screenings work and who should be screened

Each year, Aug. 1 is World Lung Cancer Day to raise awareness about lung cancer issues. This article will focus on the importance of detecting lung cancer at an early state, when it's more likely to be treated.

It is estimated that nearly 238,000 Americans will be stricken with lung cancer this year. Lung cancer is the second most common cancer and leading cause of death from cancer.

Screening, a test to check for a disease in someone who does not have any symptoms, is appropriate for some people who are in high-risk categories. Currently, lung cancer screening is covered by most insurance plans for a specific high-risk population once a year. The screening guidelines for those at high risk for lung cancer are: age 50-80 (Medicare part B currently covers ages 50-77); a current smoker or quit smoking within the last 15 years; and 20 pack-years or greater smoking history. Pack-years are calculated by multiplying the number of packs per day by the total number of years smoked.

Lung cancer can be aggressive and advance quickly between stages. This is why it is important to be screened every year until you are out of the recommended age range. Regular screenings will help your health care provider determine if any spots or abnormalities in your lungs are stable or need additional testing. Screening for lung cancer before symptoms appear is important. Without screening, most people do not see signs of lung cancer until it has spread to other areas of the body, making it harder to treat. If you are having symptoms such as cough, coughing up blood, shortness of breath, pain in chest, fatigue, hoarseness or unexplained weight loss, please talk with your healthcare provider.

Lung cancer screening uses a low-dose chest CT scan (also known as a LDCT). Currently the LDCT is the only proven method to detect lung cancer early, before symptoms occur. As with all cancer screening tests, this test in not perfect. Some cancers may still be missed. Some scans may show spots in the lung that look suspicious but may not be cancerous. These are called false positives. Similar to moles on the skin, your lungs may have spots or nodules that need to be watched, and when needed your health care provider may recommend additional testing to diagnose or rule out lung cancer. Additional testing may include a chest CT in a few months to see if the spots found during the initial LDCT have changed. In some instances, your health care provider may refer you for a minimally invasive tissue sampling or biopsy, or possible surgery or other treatments.

The LDCT is a quick and painless test. During the scan, a machine called a CT scanner takes 3D x-ray pictures of your lung using a small amount of radiation. The level of radiation is more than a chest x-ray but much lower than other types of CT scans. There are no needles or dye used during the scan. Typically, your clothing is left on and there is no need to limit eating or drinking prior to the test. The entire appointment for lung cancer screening takes about 20-30 minutes with the actual scan taking less than 10 minutes to complete. The images from the scan will be reviewed by a radiologist and the final results will be sent to your health care provider.

An important aspect of lung cancer screening is decreasing the risk of cancer. Smoking causes 80-85 percent of lung cancers in the United States. Risk increases with the number of years and packs per day a person has smoked. To reduce your risk, don't start smoking. If you smoke, take steps now to quit. Quitting tobacco use is the best thing you can do to improve your health. Talk to your healthcare provider about options to help you stop smoking and find the best way to quit. Quitting smoking improves your life in many ways, including improving your health status and quality of life, reducing the risk of premature death and decreasing the costs associated with smoking.

Please talk with your health care provider about lung cancer screening to see if you would benefit from a test.

Susan Robinson, RN, is the Care Manager and Coordinator for SSM Health Lung Cancer Screening Program. Her background includes more than 20 years as a cardiopulmonary nurse at St. Mary's Hospital. Having seen firsthand the devastating effects of smoking on the lungs, including COPD and lung cancer, she uses her knowledge and experience to help patients understand the importance of detecting lung cancer at an early state, when it's more likely to be treated. For questions about the SSM Health Lung Cancer Screening Program, please call 573-681-3753.

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