Who Should Be Screened for Lung Cancer?
Screeningexternal icon means testing for a disease when there are no symptoms or history of that disease. Doctors recommend a screening test to find a disease early, when treatment may work better.
The only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). During an LDCT scan, you lie on a table and an X-ray machine uses a low dose (amount) of radiation to make detailed images of your lungs. The scan only takes a few minutes and is not painful.
Who Should Be Screened?
The U.S. Preventive Services Task Force (USPSTF) recommendsexternal icon yearly lung cancer screening with LDCT for people who—
- Have a 20 pack-year or more smoking history, and
- Smoke now or have quit within the past 15 years, and
- Are between 50 and 80 years old.
A pack-year is smoking 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 a day for 20 years or two packs a day for 10 years.
Risks of Screening
Lung cancer screening has at least three risks—
- A lung cancer screening test can suggest that a person has lung cancer when no cancer is present. This is called a false-positive result. False-positive results can lead to follow-up tests and surgeries that are not needed and may have more risks.
- A lung cancer screening test can find cases of cancer that may never have caused a problem for the patient. This is called overdiagnosis. Overdiagnosis can lead to treatment that is not needed.
- Radiation from repeated LDCT tests can cause cancer in otherwise healthy people.
That is why lung cancer screening is recommended only for adults who are at high risk for developing the disease because of their smoking history and age, and who do not have a health problem that substantially limits their life expectancy or their ability or willingness to have lung surgery, if needed.
If you are thinking about getting screened, talk to your doctor. If lung cancer screening is right for you, your doctor can refer you to a high-quality screening facility.
The best way to reduce your risk of lung cancer is to not smoke and to avoid secondhand smoke. Lung cancer screening is not a substitute for quitting smoking.
When Should Screening Stop?
The Task Force recommends that yearly lung cancer screening stop when the person being screened—
- Turns 81 years old, or
- Has not smoked in 15 or more years, or
- Develops a health problem that makes him or her unwilling or unable to have surgery if lung cancer is found.
Insurance and Medicare Coverage
Most insurance plans and Medicare help pay for recommended lung cancer screening tests. Lung cancer screening tests may be covered by your health insurance policy without a deductible or co-pay. For more information about Medicare coverage, visit www.medicare.govexternal icon or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1 (877) 486-2048. Check with your insurance plan to find out what benefits are covered for lung cancer screening.
- Screening for Lung Cancerexternal icon (JAMA)
- Lung Cancer Screeningexternal icon (National Cancer Institute)
- Is Lung Cancer Screening Right for Me?external icon (Agency for Healthcare Research and Quality)
- Accredited Facility Searchexternal icon (American College of Radiology)
For Health Care Providers
- U.S. Preventive Services Task Force Lung Cancer Screening Collectionexternal icon (JAMA)
- Lung Cancer Screening: A Summary Guide for Primary Care Cliniciansexternal icon (Agency for Healthcare Research and Quality)
- Lung Cancer Screening: A Clinician’s Checklistexternal icon (Agency for Healthcare Research and Quality)
- Implementation of Lung Cancer Screening: Proceedings of a Workshopexternal icon (The National Academies of Sciences, Engineering, and Medicine)
- Mazzone PJ, Silvestri GA, Patel S, Kanne JP, Kinsinger LS, Wiener RS, Soo Hoo G, Detterbeck FC. Screening for lung cancer: CHEST guideline and expert panel report.external icon Chest 2018;153(4):954–985. DOI: 10.1016/j.chest.2018.01.016.external icon
- Mazzone PJ, Gould MK, Arenberg DA, Chen AC, Choi HK, Detterbeck FC, et al. Management of lung nodules and lung cancer screening during the COVID-19 pandemic: CHEST Expert Panel Report.external icon Chest 2020;158(1):406–415. DOI: 10.1016/j.chest.2020.04.020.external icon
- Increase the proportion of adults who get screened for lung cancerexternal icon (Healthy People 2030)