Lung Cancer Screening

Lung cancer happens when abnormal cells form in the lungs and can spread to other parts of your body. Most lung cancer cases in the United States are caused by smoking tobacco. Each year lung cancer kills more people than breast, prostate, and colon cancer combined. Most of the time, this is because it is found too late and has spread, which is why screening early is so important.

Why have lung cancer screening?

Lung cancer screening looks for signs of disease in patients who are high risk. We can perform this screening before you may notice any symptoms to catch cancer at an earlier stage and increase the chance of cure.

What is lung cancer screening?

Using a low-dose computed tomography (LDCT) scanner, which is a type of imaging, we take detailed "pictures" or scans of your lungs. The LDCT machine is open; your head and feet stay outside the machine. A doctor examines these pictures to look for changes that could be signs of lung cancer. It is important to schedule a low-dose CT scan every year because new cancers can grow quickly.

Who should consider screening for lung cancer?

Adults who meet the requirements below can be screened at Dartmouth Hitchcock Medical Center:

  • 50-77 years old
  • Current or former (quit within the past 15 years) smokers with at least a 20 pack-years history of smoking. To calculate 'pack-years', multiply the number of packs smoked per day by the number of years smoked.
  • No major health problems or conditions that would prevent cancer care treatment such as surgery or radiation

Note: In March 2021, the guidelines above became effective. But, some insurance companies, including Medicare, may NOT have added coverage for the new guidelines. Please check with your insurance company.

What if I do not meet the requirements for lung cancer screening?

If you don't meet these three requirements and you think you are at risk for lung cancer, tell your health care provider. There are sometimes exceptions for specific situations.

Other times, screening can be offered as part of a clinical trial.

Is lung cancer screening painful?

A lung cancer screening test is fast and painless. It doesn't require fasting or use needles, contrast (dye), or injections. There are no special preparations or precautions. It usually takes less than 15 minutes and is covered by insurance.

The benefits of lung cancer screening

When it comes to cancer, the sooner doctors spot it, the easier it is to treat. If lung cancer is diagnosed early:

  • Treatment may be more successful – Research shows spotting lung cancer at the earliest stages improves the chances of survival. The National Lung Screening Trial (NLST) study found four fewer deaths from cancer when 1,000 study participants were screened with three yearly tests. That means 20% of patients were saved by having a Lung Cancer Screening study.
  • You may have more treatment choices – Patients with early-stage lung cancer often have choices of surgery, radiation, and chemotherapy. When lung cancer is more advanced, there are fewer treatment choices available. Late-stage lung cancer is often too advanced for surgery.

Are there harms of lung cancer screening?

Leading medical societies say lung cancer screening is safe and effective for people with the highest risks of lung cancer. But the test has some drawbacks. It is important to think about both the benefits and possible harms before deciding to have a lung cancer screening.

  • False alarm – A false alarm is something that looks like lung cancer but is actually not cancer. Based on scientific reports, we expect one in five people having their first screening to have a false alarm. Most of these people will have another CT scan to prove they do not have cancer.
    Many doctors will give yearly screenings to look for changes. Sometimes, doing an extra CT scan is not enough to rule out cancer. When that happens, your doctor may recommend an invasive procedure such as a biopsy.
  • Overdiagnosis – When we screen, we sometimes find slow-growing cancers that would not have been discovered otherwise and might not lead to illness or death. When you are treated for cancer that would not have caused harm, it is called "overdiagnosis." For every 1,000 people screened, we expect that 4 will be over-diagnosed.
  • Radiation – Like an X-ray, LDCT uses radiation, a type of energy when given at high doses or many times, may be harmful or cause cancer. Studies show the risk with LDCT is very low. The amount of radiation with LDCT is much less than a regular CT scan, but a little more than an X-ray.

How to arrange for a lung cancer screening

Talk to your health care provider to decide if lung cancer screening is right for you. To learn more about lung cancer screening, contact us.

Is lung cancer screening covered by insurance?

Lung cancer screening for those who meet the requirements is covered by almost all insurance programs, including Medicare. Check with your specific health plan to find out if you have coverage. If you need help to pay for this test, please talk with our Patient Financial Services office.

Learn more about lung cancer screening