Do You Need Lung Cancer Screening? Here’s What to Know About the Expert Guidelines
Key takeaways:
Lung cancer is one of the most common and deadly cancers in the U.S. It often gets diagnosed late in the disease, but it’s much easier to treat when caught early.
To increase how many people get screened for lung cancer, the American Cancer Society updated their screening guidelines in 2023.
You should be screened for lung cancer once a year if you’re between 50 and 80 years old and currently smoke or if you smoked in the past.
Lung cancer screening uses a low-dose computed tomography (CT scan), an imaging study that raises the chances of finding lung cancer early.
Lung cancer is the second most common cancer in the U.S. — and it causes more deaths than any other type of cancer. But improved lung cancer screening could change that. Lung cancer is very treatable when it’s caught in the early stages. The key is to know who should be screened — and when.
Who should get screened for lung cancer?
Lung cancer screening is only recommended for people who smoke (or smoked in the past). That’s because studies show up to 9 in 10 of all lung cancer cases can be tied to cigarette smoking.
But that doesn’t mean that anyone who has a history of smoking automatically needs lung cancer screening.
The American Cancer Society (ACS) recommends lung cancer screening if you:
Are between 50 and 80 years old and
Currently smoke or have smoked in the past and
Have at least a 20 pack-year smoking history
A pack-year smoking history is a way to record how much people smoke over time. To calculate your pack-year history, multiply the average packs of cigarettes you smoke per day by the number of years you have smoked.
A person who smokes 1 pack per day for 20 years has a 20-year pack history. So does a person who smokes 2 packs a day for 10 years.
The ACS updated these recommendations in November 2023. So other expert groups may have slightly different recommendations. For example, the CDC has similar guidelines, but only recommends screening to people who smoke now or have quit within the past 15 years. But it’s likely this will change with future updates.
Despite any minor differences, all major expert groups agree that older adults with a long history of smoking should get screened for lung cancer.
Who does not need lung cancer screening?
People who never smoked can get lung cancer. But experts don’t recommend screening for this group of people because of the risk of false-positive results.
People who’ve been exposed to secondhand smoke for a long time are more likely to develop lung cancer than people who were not exposed to secondhand smoke. But even so, experts don’t recommend screening for these people either.
People also shouldn’t get screened if they have other medical conditions that limit their life expectancy or would prevent them from getting treatment for lung cancer. This is because the risks of a lung cancer diagnosis (or treatment for it) would likely outweigh the benefits.
Right now, recommendations apply only to smoking. In the future, similar recommendations may include vaping.
If you have a history of smoking and are wondering if screening is right for you, reach out to your healthcare provider. They can help you understand the risks and benefits particular to you and your health.
How is lung cancer screening done?
Lung cancer screening is done with low-dose computed tomography — otherwise known as a lung CT scan. This is a painless imaging study that only takes a few minutes to complete. A machine takes detailed pictures of your lungs, and a radiologist reviews the pictures to look for signs of cancer.
You can get a lung CT scan at any healthcare facility that has a CT machine. This includes outpatient imaging centers.
Experts recommend that you get a lung CT every year until your 80th birthday if you have a history of smoking.
Why is screening for lung cancer important?
Lung cancer screening is important because it gives people the chance to catch their cancer early, when it’s easier to treat.
Lung cancer usually doesn’t cause symptoms until it’s advanced, or has spread to other parts of the body. This is one of the reasons that lung cancer is the leading cause of cancer deaths. In many cases, it’s diagnosed too late to be cured.
But lung cancer screening raises your chance of finding lung cancer early — when treatments can still help. And screening is very effective — it finds over half of lung cancers at an early stage. Lung cancer is much less likely to be found early without screening.
Is lung cancer screening harmful?
Lung cancer screening isn’t painful, but there are drawbacks, including false positives and radiation exposure.
A false-positive result means that the CT scans picked up something that isn’t actually lung cancer.
A CT scan only creates pictures of the lungs. To confirm whether there’s cancer present, most people need a biopsy. This small procedure involves taking a sample of lung cells and looking at them under a microscopy. So a false-positive result puts you at risk for getting unnecessary tests and procedures.
A second drawback is radiation exposure. Any CT scan exposes your body to some radiation. But low-dose CT scans create less radiation, which makes them safer than a regular CT scan. But getting a yearly CT still exposes you to extra radiation.
For most people, these risks are very small in comparison to the benefits of finding out about lung cancer early.
The bottom line
Lung cancer screening is the best way to diagnose lung cancer in its early stages. Anyone between the ages of 50 to 80 years old with a 20 pack-year smoking history should be screened. This should be done once a year with a low-dose lung CT scan. Even though it can be scary to think about the possibility of cancer, an early diagnosis usually means the treatment is easier and more likely to be successful.
Why trust our experts?
References
Alberg, A. J., et al. (2003). Epidemiology of lung cancer. Chest.
American Cancer Society. (2023). Can lung cancer be found early?
American Cancer Society. (2023). Screening for lung cancer: 2023 guideline update from the American Cancer Society. CA: A Cancer Journal for Clinicians.
American Lung Association. (n.d.). What to expect from a lung cancer screening.
Centers for Disease Control and Prevention. (2023). Lung cancer statistics.
Centers for Disease Control and Prevention. (2023). Who should be screened for lung cancer?
