If you are at risk for lung cancer, a simple 15-minute screening could protect your health. Screening can detect cancer early when it’s easier to treat. Studies show that regular screening can help people live longer, healthier lives.

Who should get screening

The U.S. Preventive Services Task Force recommends that you get screened for lung cancer every year if you:

• Are age 50 to 80
• Have a smoking history of at least 20 “pack years” (this means smoking 1 pack a day for 20 years or 2 packs a day for 10 years, etc.)
• Smoke or quit smoking in the last 15 years

If you fit this description, you are considered at high risk for lung cancer. We recommend that you talk with your doctor about screening.

If you decide to go ahead with screening, your doctor will send us a referral. We’ll set up an appointment for a scan known as low-dose CT, or low-dose computed tomography. The scanners use low-dose X-rays to make detailed images of your lungs.

Why screening matters

If you’re at risk, low-dose CT screening can reduce your risk of dying of lung cancer.

If lung cancer is found early, before it spreads to other parts of the body, the 5-year survival rate is 8 times higher. According to the National Cancer Institute, the 5-year survival rate rises to 64% if lung cancer is caught before it spreads.

In early stages, lung cancer may have no symptoms, so screening is the best way to catch it. That’s why the OHSU Knight Cancer Institute recommends annual screening for those at high risk of lung cancer — even if you feel fine.

How screening works

The appointment takes about 15 minutes, and the scan itself takes about 2 minutes. The scanner looks like a big doughnut. You lie on a bed, and the scanner rotates around you to create the images.

How much it costs

Most people at high risk pay nothing. Medicare and most private insurance plans cover annual screening for those who meet the guidelines.

Scanning results

If your scan shows a spot, it is probably a lung nodule, or small growth. Lung nodules are common: About half the population has them. They may range from 5 millimeters (the size of a pencil eraser) to 10 millimeters (the size of a pea).

Most lung nodules are not cancer. They are usually caused by other things, like scar tissue from an old infection. They rarely cause problems, especially if they are small.

About 5% of lung nodules are cancer. A nodule is more likely to be cancer if:

• The nodule is bigger.
• You are older.
• You have smoked cigarettes.

If your scan shows a nodule, we will talk with you about options. 

We may recommend active surveillance. This means coming back for regular scans to see if the nodule has changed or grown. A small nodule that isn’t growing or changing shape probably isn’t cancer.

If the nodule is bigger or seems to be changing, we may recommend a procedure called a bronchoscopy to rule out cancer.

Downsides of screening

Risks are low, but it’s important to know that screening can result in:

• False positives: There is a small chance that screening will detect a lung nodule that is not cancer. This could lead to more tests or invasive procedures.
• False negatives: There is a small chance that screening will miss cancer, delaying treatment.
• Overdiagnosis: There is a small chance that screening will find lung cancer that would have stopped growing or vanished on its own. This could lead to unnecessary treatments and anxiety.
• Radiation exposure: Radiation from a CT scan raises the risk, by a tiny amount, of developing cancer later.

Talk with your doctor before you decide to get screened.

Learn more

• Lung Cancer Screening – Patient Version, National Cancer Institute
• Who Should Be Screened for Lung Cancer? U.S. Centers for Disease Control and Prevention
• About Low-Dose Lung Cancer Screening, American Lung Association
• What to Expect from a Lung Cancer Screening, American Lung Association