Monday August 2, 2021
Should You Be Screened for Lung Cancer?
What can you tell me about lung cancer screenings? I quit smoking years ago, but I am wondering if I should be checked out.
Lung cancer screening is used to detect the presence of lung cancer in otherwise healthy people with a high risk of developing lung cancer. Whether you should be screened depends on your age and your smoking history. Here is what you should know.
The U.S. Preventive Services Task Force – an independent panel of medical experts that advises the government on health policies – recently expanded its recommendation for lung cancer screenings. It now recommends annual screenings for high-risk adults. Those considered high-risk are individuals between the ages of 50 and 80 who have a 20 pack-year history, who currently smoke or who have quit within the past 15 years. This is a change from the 2013 recommendation that referred to patients ages 55 to 80 with 30 pack-year histories.
A 20 pack-year history is the equivalent of smoking one pack a day for 20 years or two packs a day for 10 years.
In 2020, lung cancer killed more than 135,000 Americans making it the deadliest of all possible cancers. In fact, more people die of lung cancer than of colon, breast and prostate cancers combined.
Lung cancer also occurs predominantly in older adults. About two out of every three people diagnosed with lung cancer are age 65 or older.
Fortunately, many health insurance plans cover lung cancer screenings for high-risk patients, as does Medicare for ages 55 to 77.
Screening Pros and Cons
Doctors use a low-dose computed tomography scan, also called a low-dose CT scan (LDCT) to look for lung cancer. If lung cancer is detected at an early stage, it is more likely to be responsive to treatment. However, a LDCT scan is not recommended for every high-risk patient.
LDCT scans have a high rate of false positives, which means that many will undergo additional screening or medical procedures. This may include additional scans three, six or even 12 months later to check for changes in the shape or size of the suspicious area, which is an indication of tumor growth. For some patients, the anxiety or worry that goes along with waiting can be a real issue.
Instead, you may need a biopsy, which requires a removal of a small amount of lung tissue. Biopsies have some risks, especially for those with underlying health conditions, such as chronic obstructive pulmonary disease or emphysema. For example, for people with emphysema, there is a chance of a lung collapsing during the procedure.
If you meet the U.S. Preventive Services Task Force criteria for high-risk of lung cancer, look to free online tools or quizzes to help you decide if you should get a LDCT scan. It is important to discuss the benefits and risks with your primary care doctor before making a decision.
Tips for Testing
If you and your doctor determine that you should be screened, look for an imaging facility whose staff follows American College of Radiology requirements when performing LDCT scans. You can find accredited facilities at ACRaccreditation.org.
This can help to ensure your scans are reviewed by a highly trained, board-certified or board-eligible radiologist.
You may need a referral from your primary care provider prior to undergoing a screening. Some insurance companies, including Medicare, require a referral before they will cover the cost of screening.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
Published May 28, 2021
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