Lung Can­cer Screening

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the lungs, it is called lung cancer.

Lung cancer begins in the lungs and may spread to lymph nodes or other organs in the body, such as the brain. Cancer from other organs also may spread to the lungs. When cancer cells spread from one organ to another, they are called metastases.

Lung cancers usually are grouped into two main types called small cell and non-small cell (including adenocarcinoma and squamous cell carcinoma). These types of lung cancer grow differently and are treated differently. Non-small cell lung cancer is more common than small cell lung cancer.

Research has found several risk factors that may increase your chances of getting lung cancer.

Smoking

Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancer deaths. Using other tobacco products such as cigars or pipes also increases the risk for lung cancer. Tobacco smoke is a toxic mix of more than 7,000 chemicals. Many are poisons. At least 70 are known to cause cancer in people or animals.

People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. Even smoking a few cigarettes a day or smoking occasionally increases the risk of lung cancer. The more years a person smokes and the more cigarettes smoked each day, the more risk goes up.

People who quit smoking have a lower risk of lung cancer than if they had continued to smoke, but their risk is higher than the risk for people who never smoked. Quitting smoking at any age can lower the risk of lung cancer.

Cigarette smoking can cause cancer almost anywhere in the body. Cigarette smoking causes cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, voicebox (larynx), trachea, bronchus, kidney and renal pelvis, urinary bladder, and cervix, and causes acute myeloid leukemia.

Secondhand Smoke

Smoke from other people’s cigarettes, pipes, or cigars (secondhand smoke) also causes lung cancer. When a person breathes in secondhand smoke, it is like he or she is smoking. In the United States, one out of four people who don’t smoke, including 14 million children, were exposed to secondhand smoke during 2013 to 2014.

Radon

After smoking, radon is the second leading cause of lung cancer in the United States. Radon is a naturally occurring gas that forms in rocks, soil, and water. It cannot be seen, tasted, or smelled. When radon gets into homes or buildings through cracks or holes, it can get trapped and build up in the air inside. People who live or work in these homes and buildings breathe in high radon levels. Over long periods of time, radon can cause lung cancer.The U.S. Environmental Protection Agency (EPA)external icon estimates that radon causes about 21,000 lung cancer deaths each year. The risk of lung cancer from radon exposure is higher for people who smoke than for people who don’t smoke. However, the EPA estimates that more than 10% of radon-related lung cancer deaths occur among people who have never smoked cigarettes. Nearly one out of every 15 homes in the United States has high radon levels. Learn how to test your home for radon and reduce the radon level if it is high.

Other Substances

Examples of substances found at some workplaces that increase risk include asbestos,arsenic,diesel exhaust, and some forms of silica and chromium. For many of these substances, the risk of getting lung cancer is even higher for those who smoke.

Personal or Family History of Lung Cancer

If you are a lung cancer survivor, there is a risk that you may develop another lung cancer, especially if you smoke. Your risk of lung cancer may be higher if your parents, brothers or sisters, or children have had lung cancer. This could be true because they also smoke, or they live or work in the same place where they are exposed to radon and other substances that can cause lung cancer.

Radiation Therapy to the Chest

Cancer survivors who had radiation therapy to the chest are at higher risk of lung cancer.

Diet

Scientists are studying many different foods and dietary supplements to see whether they change the risk of getting lung cancer. There is much we still need to know. We do know that people who smoke and take beta-carotene supplements have increased risk of lung cancer.

Also, arsenic and radon in drinking water (primarily from private wells) can increase the risk of lung cancer.

Different people have different symptoms for lung cancer. Some people have symptoms related to the lungs. Some people whose lung cancer has spread to other parts of the body (metastasized) have symptoms specific to that part of the body. Some people just have general symptoms of not feeling well. Most people with lung cancer don’t have symptoms until the cancer is advanced. Lung cancer symptoms may include—

• Coughing that gets worse or doesn’t go away.
• Chest pain.
• Shortness of breath.
• Wheezing.
• Coughing up blood.
• Feeling very tired all the time.
• Weight loss with no known cause.

Other changes that can sometimes occur with lung cancer may include repeated bouts of pneumonia and swollen or enlarged lymph nodes (glands) inside the chest in the area between the lungs.

These symptoms can happen with other illnesses, too. If you have some of these symptoms, talk to your doctor, who can help find the cause.

You can help lower your risk of lung cancer in the following ways—

• Don’t smoke. Cigarette smoking causes about 80% to 90% of lung cancer deaths in the United States. The most important thing you can do to prevent lung cancer is to not start smoking, or to quit if you smoke.
• Avoid secondhand smoke. Smoke from other people’s cigarettes, cigars, or pipes is called secondhand smoke. Make your home and car smoke-free.
• Get your home tested for radon. The U.S. Environmental Protection Agency recommends that all homes be tested for radon.
• Be careful at work. Health and safety guidelines in the workplace can help workers avoid carcinogens—things that can cause cancer.

Need Help Quitting?

• Visit smokefree.gov
• Call 1 (800) QUIT-NOW
• Text "QUIT" to 47848 from your cell phone

Screening 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) recommends 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. Check with your insurance plan to find out what benefits are covered for lung cancer screening. For more information about Medicare coverage, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1 (877) 486-2048.