Low-Does CT Scans for Lung Cancer

Lung cancer is often diagnosed late, when you might have symptoms like wheezing, hacking or coughing up blood. Lung cancer symptoms are silent early on, so early disease often goes undetected. Lung cancer is the leading cause of cancer deaths in the U.S., and smoking is often the culprit.

Fortunately, a quick, painless screening test can look for early-stage lung cancer, when the condition is easier to treat, in current and former smokers.

Doctors use low-dose CT scan to screen for lung cancer in eligible people. The test only takes a few minutes. You’ll be asked to lie down on a table, which slides into and out of a CT scan machine. The machine uses X-ray technology to create detailed images of your lungs.

Finding lung cancer early may change the course of your illness. Your treatment may be simpler and less expensive. You may feel healthier and live longer.

Who is eligible for a low-dose CT scan?

The screening test is recommended for certain people at high risk of lung cancer.

To be screened, you must:

• Be between the ages of 50 and 80.
• Have no lung cancer symptoms or a previous lung cancer diagnosis.
• Be a current smoker or someone who stopped smoking less than 15 years ago.
• Have a 20-pack-year smoking history (such as one pack of cigarettes a day for 20 years or two packs a day for 10 years).

Who isn’t eligible for a low-dose CT scan?

You won’t be able to get a screening if:

• You’re under age 50.
• You’re 81 or older.
• It’s been more than 15 years since you stopped smoking.
• You already have symptoms of lung cancer.
• You’re unwilling or unable to seek treatment after a possible diagnosis.

Can I be screened for lung cancer if I still smoke?

Yes, but expect your doctor to discuss smoking cessation with you. If you aren’t willing to quit, they may recommend that you cut back to five or fewer cigarettes daily, to decrease your lung cancer risk.

What happens if doctors find something during low-dose CT-scan?

Screening may identify small nodules (lumps) in the lungs. In most cases, they’re benign (non-cancerous), but your doctor should send you for additional testing. You may need a standard CT scan, PET/CT scan or biopsy. Doctors sometimes watch a small nodule over time, to see if it changes.

Is this lung cancer screening test used as widely as other cancer screening tests, like mammograms or colonoscopy?

No. Only 18% of patients who meet the criteria have been screened for lung cancer, according to the Centers for Disease Control and Prevention. There are several possible reasons for this.

The U.S. Preventive Services Task Force recommendation for lung cancer screening is relatively new; it’s only been around since 2021. Primary-care providers may not prioritize lung cancer screening during well visits because it hasn’t been on their radar for as long as colonoscopy or mammography.

Some people who are eligible for lung cancer screening have not disclosed their smoking history to their doctors. Your doctor can’t offer you screening if they don’t know that you would qualify.

Primary-care providers may not take time to discuss lung cancer screening because of time constraints. They only have a few minutes to meet with patients. A discussion about low-dose CT scan requires shared decision-making, which would limit the time they could devote to other health concerns.

What is “shared decision-making,” and how does it relate to lung cancer screening?

Shared decision-making means that your doctor discusses the risks and benefits of low-dose CT scan with you. If you’re eligible for a low-dose CT scan, you and your doctor must decide that getting screened is a good idea before they can send you for screening.

Low-dose CT scan for lung cancer is the only screening test that requires shared decision-making. Your doctor doesn’t have to tell you about the pros and cons of mammography or colonoscopy before sending you for those tests. It’s an extra step that makes it harder for current and former smokers to get screened.

If you want to be screened, be your own health advocate. Tell your doctor that you meet the criteria and you’d like them to send you for a low-dose CT scan.

Will a low-dose CT scan expose me to radiation?

Yes, but it’s a low-level exposure. You’ll be exposed to about one-sixth of the radiation dosage as a standard CT scan. It’s about equivalent to the amount of radiation exposure you’d get during a chest X-ray.

Some people worry about possible risks associated with radiation exposure. Before any medical screening, you should weigh the risks and benefits. If you meet the criteria for the lung cancer screening, you have a high risk of lung cancer, which has a high mortality rate. With this in mind, you may decide that the benefits of an early lung cancer diagnosis outweigh any possible risks from low-dose radiation exposure.

If I go for a low-dose CT scan, is it a one-time screening?

No. In order for low-dose CT scan to be an effective screening tool, you’ll need to get screened annually. Having a clean scan this year doesn’t mean that you won’t develop lung cancer in the upcoming year.

If you have a history of smoking and meet the screening criteria, contact the Lung Health and Screening Program at 302-623-0552 to schedule low-dose CT screening for lung cancer.