Lung cancer screening is a way to find some lung cancers early, when a cure is more likely.
Lung cancer screening may help those who have the highest risk for lung cancer—people 55 and older who are or were heavy smokers. For most people, who aren't at increased risk, screening for lung cancer probably isn't helpful.
Screening won't prevent cancer. And it may not find all lung cancers. Lung cancer screening may lower the risk of dying from lung cancer in a small number of people.
Lung cancer screening is done with a low-dose CT (computed tomography) scan. A CT scan uses X-rays, or radiation, to make detailed pictures of your body. Experts recommend that screening be done in medical centres that focus on finding and treating lung cancer.
Lung screening is only recommended for people who are or were heavy smokers. That means people with a smoking history of at least 30 pack years. A pack year is a way to measure how heavy a smoker you are or were.
To figure out your pack years, multiply how many packs a day on average (assuming 20 cigarettes per pack) you have smoked by how many years you have smoked. For example:
The Canadian Task Force on Preventive care recommends lung cancer screening if:
CT screening for lung cancer isn't perfect. It can show an abnormal result when it turns out there was not any cancer. This is called a false-positive result. This means you may need more tests to make sure you don't have cancer. These tests can be harmful and cause a lot of worry.
These tests may include more CT scans and invasive testing like a lung biopsy. In a biopsy, the doctor takes a sample of tissue from inside your lung so it can be looked at under a microscope. A biopsy is the only way to tell if you have lung cancer. If the biopsy finds cancer, you and your doctor will have to decide how or whether to treat it.
Some lung cancers found on CT scans are harmless and would not have caused a problem if they had not been found through screening. But because doctors can't tell which ones will turn out to be harmless, most will be treated. This means that you may get treatment—including surgery, radiation, or chemotherapy—that you don't need.
There is a small chance of getting cancer from being exposed to radiation. A low-dose CT scan uses more radiation than a regular chest X-ray. But it uses much less than a regular-dose CT scan. You and your doctor will decide if the possibility of finding lung cancer early is worth the risk of having this test and being exposed to the radiation.
Your scan may be normal (negative).
For some people who are at higher risk, screening lowers the chance of dying of lung cancer. How much and how long you smoked helps to determine your risk level. Screening can find some cancers early, when treatment may be more likely to work.
The results of your CT scan will be sent to your doctor. Someone from your care team will explain the results of your scan and answer any questions you may have. If you need any follow-up, he or she will help you understand what to do next.
After a lung cancer screening, you can go back to your usual activities right away.
A lung cancer screening test can't tell if you have lung cancer. If your results are positive, your doctor can't tell whether an abnormal finding is a harmless nodule, cancer, or something else without doing more tests.
Don't smoke. Most lung cancers are caused by smoking. If you have already quit smoking, you've taken the best step you can to prevent lung cancer. And if you still smoke, the best way to lower your chance of getting or dying from lung cancer is to quit. Your doctor may recommend medicines that can help you quit.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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Current as of: March 28, 2018
Adam Husney, MD - Family Medicine
& Thomas M. Bailey, MD, CCFP - Family Medicine & Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Michael P. Pignone, MD, MPH, FACP - Internal Medicine
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