Health Matters 7/2: The Benefits of Lung Cancer Screening

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By John A. Heim, MD  

By the time lung cancer causes symptoms, such as a chronic cough or difficulty breathing, the disease is usually in an advanced stage when it is more difficult to treat.

However, when detected early, lung cancer can often be treated, and in many cases, cured.

If you think you are a candidate for lung cancer screening, talk with your doctor. Penn Medicine Princeton Medical Center’s Lung Cancer Screening Program offers testing for those who meet screening criteria.

The National Lung Screening Trial (NLST) and the American Cancer Society guidelines recommend lung cancer screening for people who are current or former smokers; are aged 55-74; have a smoking history of one pack per day for 30 years or 2 packs per day for 15 years; and those who do not have a history of lung cancer.

Smoking Increases Risk  

Lung cancer is the leading cause of cancer death among men and women, accounting for nearly 25 percent of all cancer deaths each year, according to the American Cancer Society.

Moreover, as the American Cancer Society notes, about 80 percent of lung cancer deaths are thought to result from smoking. Specifically, the longer you smoke and the more packs a day you smoke, the greater your risk.

The best way to reduce your risk of dying from lung cancer is to quit smoking and continue to stay smoke-free. If you stop smoking before cancer develops, your damaged lung tissue gradually begins to heal. No matter your age, or how long you’ve smoked, it is never too late to quit.

Low-Dose CT Scans Save Lives  

Screening for lung cancer can be a lifesaver. Specifically, CT screening that uses low-dose radiation to make a series of detailed pictures of areas in the body. The pictures are made by a computer linked to an X-ray machine that scans the body in a spiral path. The scan takes just a few minutes and does not require any pre-operative lab work. Results are normally available within a matter of days.

Regular chest X-rays are not recommended for lung cancer screening. Research has shown that using low-dose CT scans to screen people at higher risk for lung cancer saved more lives compared to chest X-rays.

The American Cancer Society recommends that screening only be done at facilities that have the right type of CT scanner and that have experience in low-dose CT scans for lung cancer screening. The facility should also have a team of specialists that can provide appropriate care and follow-up if there are abnormal results on the scans.

For higher risk individuals, getting a yearly low-dose CT scan before lung cancer symptoms develop helps lower the risk of dying from lung cancer.

The Lung Cancer Screening Program at Princeton Medical Center is a collaborative effort involving board certified radiologists, surgeons, pulmonologists, and oncologists who work together to detect and treat lung cancer.

Patients who meet the criteria need only a prescription from their primary care doctor or other physician to schedule a screening.

Scans like those offered at Princeton Medical Center can identify lung cancer nodules in high-risk individuals before symptoms begin and can help save lives.

After your low-dose CT scan, the results are sent to your primary care physician and/or the physician who ordered the test. If it is necessary, the program’s Nurse Navigator works with your physician to ensure that appropriate follow-up care is received.

New Screening Guidelines  

New guidelines recently released by the U.S. Preventive Services Task Force have expanded the eligibility criteria for lung cancer screening, with evidence showing that screening can help many more people who are at high risk for the disease. These guidelines are expected to be widely adopted by health insurance companies and health care providers in 2022.

In its recommendations, the task force has made two changes that nearly double the number of people eligible for lung cancer screening.

First, the task force recommends that people start screening at age 50, rather than 55. Second, the recommendations reduce the pack-years of smoking history that make someone eligible for screening from 30-pack years to 20.

A pack-year is a way of calculating how much a person has smoked. One pack-year is the equivalent of smoking an average of 20 cigarettes, or one pack, per day for a year.

The task force notes that by expanding who is eligible for screening, the changes will be especially helpful to Black people and women. According to the task force, data shows that both groups tend to smoke fewer cigarettes than white men. Data also shows that Black people have a higher risk of lung cancer than White people.

The new guidelines mean that many more Black people and women who smoke will be eligible for potentially lifesaving screening, according to the task force.


Talk to Your Doctor 

If you are a current or former smoker, talk with your doctor about whether you are at high risk for lung cancer and if screening may be right for you. You should also see your doctor promptly if you are having any symptoms.

According to the American Lung Cancer Association, symptoms of lung cancer include:
A cough that doesn’t go away and gets worse over time
Hoarseness
Constant chest pain
Shortness of breath or wheezing
Frequent lung infections such as bronchitis or pneumonia
Coughing up blood

Some symptoms of lung cancer may not seem related to the lungs or breathing. These symptoms can still be a sign of lung cancer because lung cancer usually does not cause symptoms in its earlier stages. The symptoms include weight loss, loss of appetite, headaches, bone pain or fractures, or blood clots.

To schedule an appointment for lung cancer screening at Princeton Medical Center, call 609-853-7070. To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.

John A. Heim, MD, is board certified in general and thoracic surgery and is the chairman of the Department of Surgery at Penn Medicine Princeton Health.