For patients
If you fit all of the criteria listed above for lung cancer screening, you and your doctor (or other health care provider) should talk about screening, including possible benefits and harms, as well as the limitations of screening.
The main benefit is a lower chance of dying of lung cancer, which accounts for many deaths in current and former smokers. Still, it’s important to be aware that, like with any type of screening, not everyone who gets screened will benefit. Screening with LDCT will not find all lung cancers, and not all of the cancers that are found will be found early. Even if a cancer is found by screening, you may still die from lung cancer. Also, LDCT often finds things that turn out not to be cancer, but have to be checked out with more tests to know what they are. You might need more CT scans, or even invasive tests such as a lung biopsy, in which a piece of lung tissue is removed with a needle or during surgery. These tests have risks of their own (see above).
Screening should only be done at facilities that have the right type of CT scanner and that have a lot of experience in LDCT scans for lung cancer screening. The facility should also have a team of specialists that give patients the appropriate care and follow-up if there are abnormal results on the scans. You might not have the right kind of facility nearby, so you may need to travel some distance to be screened.
If you and your doctor decide that you should be screened, you should get a LDCT every year until you reach the age of 74, as long as you are still in good health.
If you smoke, you should get counseling about stopping. You should be told about your risk of lung cancer and referred to a smoking cessation program. Screening is not a good alternative to stopping smoking. For help quitting, see our Guide to Quitting Smoking or call the American Cancer Society at 1-800-227-2345.
What does “in fairly good health” mean?
Screening is meant to find cancer in people who do not have symptoms of the disease. People who already have symptoms that might be caused by lung cancer may need tests such as CT scans to find the underlying cause, which in some cases may be cancer. But this kind of testing is for diagnosis and is not the same as screening. Some of the possible symptoms of lung cancer that kept people out of the NLST were coughing up blood and weight loss without trying.
To get the most benefit from screening, patients need to be in good health. For example, they need to be able to have surgery and other treatments to try to cure lung cancer if it is found. Patients who need home oxygen therapy probably couldn’t withstand having part of a lung removed, and so are not candidates for screening. Patients with other serious medical problems that would shorten their lives or keep them from having surgery might not benefit enough from screening for it to be worth the risks, and so should also not be screened.
Metal implants in the chest (like pacemakers) or back (like rods in the spine) can interfere with x-rays and lead to poor quality CT images of the lungs. People with these types of implants were also kept out of the NLST, and so should not be screened with CT scans for lung cancer according to the ACS guidelines.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Last Medical Review: February 22, 2016 Last Revised: May 16, 2016
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