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Lung Cancer and Screening: Who should be screened for lung cancer?

By Sergio Bures, MD FCCP | Pulmonology

Lung cancer remains the leading cause of cancer death in the US with over 160,000 deaths a year.  It is the second most common cancer diagnosed in both men and women with approximately 173,000 new cases diagnosed each year.   Although approximately 10% of lung cancers are diagnosed in people who have never smoked, the great majority of lung cancers are related to smoking, which remains the leading cause of this disease.  When considering all stages of lung cancer, the mortality is very high because the great majority of lung cancers are routinely found at advanced stages, when surgical resection for cure is no longer possible.  Recently, large randomized trials have shown a significant survival benefit with a 20% decrease in mortality with low dose CT scanning in order to identify lung cancer in its early stages.  Surgery of early lung cancer has been shown to greatly impact survival, with an approximate cure rate above 60% for early stage disease in adequate surgical candidates.  Given this information and the proven survival benefit when lung cancer is found early,  many different health organizations now recommend yearly low dose CT scan screening be performed on patients considered at high risk for lung cancer.

Who should be screened for lung cancer?

Currently only high risk patients are considered candidates for low dose CT screening.  This category includes active or former smokers who quit within the last 15 years, ages 55-80 with a greater than 30 pack/year history of smoking (1 pack per day for 1 year=1 pack/year history). If abnormalities are found that require other scans or interventions, then medical insurance would cover those expenses in most circumstances.  If you are one of these high risk patients, based on the above criteria, you should discuss this issue with your primary care doctor who can help you decide and arrange the appropriate screening intervention based on your personal history.  Of course, smoking cessation remains by far the most important measure to decrease your personal risk of lung cancer and to improve your general overall health.