Lung Screening

A lung screening test is a type of CT scan used to detect lung cancer for high-risk patients. A CT scan is a painless examination that gives your physician an unobstructed look at organs and structures that cannot be seen on conventional X-Rays. The scanner obtains image data from different angles around the body and uses computer processing to show a cross-section of the body tissues and organs.

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.

How to detect lung cancer: Symptoms

Many times, symptoms do not manifest themselves in the early stages of lung cancer. Instead, most lung cancers are diagnosed in the late stages of the disease, making treatment more problematic and as a result significantly reducing the overall lung cancer survival rate.

But, there are some classic symptoms of lung cancer that, by themselves, are generally not a cause for worry. If you experience any of these symptoms, please talk to your doctor to rule out lung cancer:

Persistent cough (especially if you are coughing up rust-colored sputum)
Shortness of breath
Hoarseness
Chronic bronchitis
Chest pain
Unexplained weight loss
Bone pain

How to detect lung cancer: Risk factors

Lung cancer screening carries several risks, such as:

Being exposed to a low level of radiation. The amount of radiation you're exposed to during an LDCT is much less than that of a standard CT scan. It's equal to about half the radiation you're exposed to naturally from the environment in a year.

Undergoing follow-up tests. If your scan shows a suspicious spot in one of your lung, you may need to undergo additional scans, which expose you to more radiation, or invasive tests, such as a biopsy, which carry serious risks. If these additional tests show that you don't have lung cancer, you may have been exposed to serious risks that you would have avoided if you didn't undergo screening.

Finding cancer that's too advanced to cure. Advanced lung cancers, such as those that have spread, may not respond well to treatment, so finding these cancers on a lung cancer screening test might not improve or extend your life.

Finding cancer that may never hurt you. Some lung cancers grow slowly and may never cause symptoms or harm. It's difficult to know which cancers will never grow to hurt you and which ones must be removed quickly to avoid harm. If you're diagnosed with lung cancer, your doctor will likely recommend treatment. Treatment for cancers that would have remained small and confined the rest of your life may not help you and may be unnecessary.

Missing cancers. It's possible that lung cancer may be obscured or missed on your lung cancer screening test. In these cases, your results may indicate that you don't have lung cancer when you actually do.

Finding other health problems. People who smoke for a long time have an increased risk of other health problems, including lung and heart conditions that may be detected on a lung CT scan. If your doctor finds another health problem, you may undergo further testing and, possibly, invasive treatments that wouldn't have been pursued if you hadn't had lung cancer screening.

How you prepare

To prepare for an LDCT scan, you may need to:

Inform your doctor if you have a respiratory tract infection. If you currently have signs and symptoms of a respiratory tract infection or if you recently recovered from an infection, your doctor may recommend delaying your screening until one month after your signs and symptoms go away. Respiratory infections can cause abnormalities on CT scans that might require additional scans or tests to investigate. These additional tests can be avoided by waiting for the infection to resolve.

Remove any metal you're wearing. Metals can interfere with the imaging, so you may be asked to remove any metal that you might be wearing, such as jewelry, glasses, hearing aids and dentures.

Wear clothes that don't have metal buttons or snaps. Don't wear an underwire bra. If your clothing has too much metal, you may be asked to change into a gown.

During lung cancer screening

During an LDCT scan of the lungs, you lie on your back on a long table. You may be given a pillow to make you more comfortable.

The technologist who runs your scan will move to a separate room where he or she can still see you and talk with you.

You'll be asked to lie very still as the table slides through the center of a large machine that creates the images of your lungs. The table passes through the machine initially to determine the starting point for the scan.

When the machine is ready to start the scan, you may be asked to hold your breath briefly in order to create a clear picture of your lungs. The table will move quickly through the machine as the images are created. The machine may make knocking or clicking noises.

Expect your appointment to last about a half-hour, though the actual scan takes less than a minute.

After lung cancer screening

When your LDCT scan is complete, you can go about your day normally.

The images created during the scan are compiled by a computer and reviewed by a doctor who

specializes in diagnosing lung cancer with imaging tests (chest radiologist).

Results

Examples of lung cancer screening results include:

No abnormalities discovered. If no abnormalities are discovered on your lung cancer screening test, your health care provider may recommend you undergo another scan in a year. You may consider continuing annual scans until age 80 or until you and your doctor determine they are unlikely to offer a benefit, due to other significant health issues you may have.

Lung nodules. Lung cancer may appear as a small spot in the lungs. Unfortunately, many other lung conditions look the same, including scars from lung infections and noncancerous (benign) growths. In studies, as many as half the people undergoing lung cancer screening have one or more nodules detected on an LDCT.

Most small nodules don't require immediate action and will be monitored at your next annual lung cancer screening. In some cases, the results may suggest the need for another lung CT scan in a few months to see if the lung nodule grows. Growing nodules are more likely to be cancerous.

A large nodule is more likely to be cancerous. For that reason, you might be referred to a lung specialist (pulmonologist) for additional tests, such as a procedure (biopsy) to remove a piece of a large nodule for laboratory testing, or for additional imaging tests, such as a positron emission tomography (PET) scan.

Other health problems. Your lung cancer screening test may detect other lung and heart problems that are common in people who have smoked for a long time, such as emphysema and hardening of the arteries in the heart. Discuss these findings with your health care provider to determine if additional tests are indicated.

If you have any further questions or concerns, please let our office staff know. We will be happy to work through any questions you may have.

*information courtesy of the Mayo Clinic. More details can be found here.