Lung cancer screenings: Early detection for a deadly disease

Should I get screened for lung cancer? When should I start screenings? Are there any risks?

Lung cancer screenings can provide early detection for a deadly form of cancer, but many don’t know the test—using low-dose computed tomography—is an option.

We asked Abbie Begnaud, MD, a pulmonologist and critical care physician with M Health Fairview, for answers to some common lung cancer screening questions. Begnaud explains who should receive a screening and what patients should expect during their screening.

Why are lung cancer screenings important?

Lung cancer is the leading cause of death from cancer in the United States. Unfortunately, early lung cancer typically has no symptoms. By the time a person with lung cancer has symptoms, the cancer is likely to have spread or metastasized. Because most people are diagnosed when the cancer is already at an advanced stage, it is life-threatening and difficult to treat.

While lung cancer screenings can’t prevent you from getting cancer, they can help detect cancer in its earliest stages, when it is treatable and potentially curable. Annual screening can help lower the risk of death from lung cancer by nearly 20 percent.

Who should receive them?

Lung cancer screening is recommended for current and former smokers based on age and smoking history. National guidelines currently recommend yearly screening for people who:

• Have smoked at least a pack of cigarettes a day for 20 or more years and
• Smoke now or have quit within the last 15 years and
• Are between 50 and 80 years old

If you meet these criteria, you are a good candidate for annual lung cancer screening. However, if you have a new cough or shortness of breath, you should talk to your doctor before being screened.

“Only high-risk patients should be screened. Screening can be lifesaving, but also has potential downsides that do more harm than good if a person has a low risk of lung cancer,” said Begnaud. “Although other factors contribute to lung cancer risk, eligibility for screening is based mainly on a person’s smoking history.”

When should screenings begin?

All high-risk smokers who are eligible should get screened when they turn 50. Eligible patients older than 50 who have not yet received a screening should consider the procedure as well.

What risks are associated with screening?

For high-risk patients, the benefits of a screening greatly outweigh the risks. However, there are still some points a person should consider before screening.

Patients must limit how often they’re screened, because there is a risk of radiation exposure, Begnaud said. Lung cancer screenings also have a relatively high false-positive rate. Roughly 25 percent of patients receive a positive result, but the cause of the false positive may actually be an old infection, scar in their lung, or other source. These patients may receive a letter notifying them about the possibility of cancer, but they should consult with their doctor before drawing conclusions.

“If you get a positive result it doesn’t necessarily mean that there is a problem, it just means we may need to do further testing,” Begnaud said.

Do I need to do anything to prepare for my screening?

No preparation is needed prior to a lung cancer screening.

What should I expect at my screening?

When you check in, you will likely be asked to complete a short questionnaire about your smoking history and any other risk factors, including family history. The screening itself is a very speedy process and takes less than a minute to complete. It is also a painless, Begnaud said.

What makes our lung cancer screening program different?

M Health Fairview University of Minnesota Medical Center is recognized by the nonprofit GO2 For Lung Cancer (formerly the Lung Cancer Alliance and the Bonnie J. Addario Lung Cancer Foundation) as a Screening Center of Excellence, one of just a handful in Minnesota. This means we adhere to the highest standards for screening and treatment protocols by working as a multidisciplinary clinical team to deliver coordinated, comprehensive care for screening, diagnosis, and treatment.

"Having a multidisciplinary team in place ensures that we can take a personalized approach to the diagnosis and treatment of any abnormalities we find on a screening exam,” Begnaud said.