Smoked in the Past? This 10-Minute Scan Could Save Your Life

Lung cancer is the leading cause of cancer death in the United States. It claims more lives than colon, breast, and prostate cancer combined. Yet most people who qualify for lung cancer screening have never been screened. Many don't even know the test exists.

That needs to change, because screening works. When lung cancer is found early, before it causes symptoms, the chance of a cure is dramatically higher.

What Is Lung Cancer Screening?

Lung cancer screening uses a low-dose CT scan (LDCT). You lie on a table while a scanner takes detailed images of your lungs. There are no needles, no prep, and no sedation. The scan itself takes less than a minute, and the whole visit is usually done in about 10 minutes.

It uses much less radiation than a standard CT scan. Large clinical trials have shown that annual low-dose CT screening reduces lung cancer deaths by about 20% compared with chest X-rays in people at high risk.

Do You Qualify?

The U.S. Preventive Services Task Force recommends yearly screening if you meet all three of these criteria:

• You're between 50 and 80 years old

• You have a 20 pack-year smoking history

• You currently smoke, or quit within the past 15 years

  
  

The American Cancer Society goes a step further and recommends screening regardless of how long ago you quit, as long as you meet the age and pack-year criteria. If you quit more than 15 years ago, ask your doctor whether screening makes sense for you.

What Is a Pack-Year?

A pack-year is a way to measure how much you've smoked over time. Multiply the number of packs you smoked per day by the number of years you smoked.

For example:

• 1 pack a day for 20 years = 20 pack-years

• 2 packs a day for 10 years = 20 pack-years

• Half a pack a day for 40 years = 20 pack-years

  
  

Many people are surprised to find they qualify. Someone who smoked half a pack a day from their late teens through their fifties easily reaches 20 pack-years.

Why So Few People Get Screened

Fewer than 1 in 5 eligible Americans get screened for lung cancer. Common reasons include:

• Doctors not bringing it up

• Patients not knowing they qualify

• Stigma and shame around smoking

• Fear of what the scan might find

  
  

Let me say this clearly as a cancer surgeon: you deserve screening, no matter your smoking history. Smoking is an addiction, not a moral failing, and early detection is your right.

Screening and Health Equity

In 2021, the screening guidelines were expanded by lowering the starting age from 55 to 50 and the smoking threshold from 30 to 20 pack-years. This change was especially important for Black Americans and women. Research showed that many Black smokers develop lung cancer at younger ages and after smoking fewer cigarettes, so the old criteria left too many people out. [read more in our Disparities series]

Even with the expansion, screening rates remain lower in underserved communities. Closing that gap saves lives.

What Happens If Something Shows Up?

Most scans are normal. When something is found, it's usually a small spot called a nodule, and the vast majority of nodules are not cancer. Your care team will typically recommend a follow-up scan to see whether it changes over time. Only a small number of people need a biopsy or further testing.

Screening is not a substitute for quitting. If you still smoke, quitting at any age lowers your risk, and your screening visit is a great time to ask for help.

Don't Wait If You Have Symptoms

Screening is for people without symptoms. If you have a cough that won't go away, coughing up blood, chest pain, shortness of breath, hoarseness, or unexplained weight loss, see a doctor now.

Frequently Asked Questions

Does Medicare cover lung cancer screening?Yes. Medicare covers annual low-dose CT screening for eligible adults, currently ages 50 to 77, after a shared decision-making visit with your provider. Most private insurers cover it for people who meet USPSTF criteria.

I've never smoked. Should I be screened?Current guidelines don't recommend routine screening for people who have never smoked. But lung cancer can occur in nonsmokers, so talk with your doctor about symptoms or other risk factors such as radon exposure or family history.

How often should I get screened?Once a year, for as long as you meet the criteria and are healthy enough to benefit from treatment.

Is the radiation dangerous?A low-dose CT uses far less radiation than a standard CT. For people at high risk, the benefit of finding cancer early outweighs the small radiation risk.

Take the Next Step with EDDIE Lung

Not sure whether you qualify, or have questions about your results? EDDIE Lung, your AI-powered lung cancer copilot, can walk you through it in plain language, 24/7. Download it free on the App Store today.

This article is for educational purposes only and is not a substitute for professional medical advice. Talk with your healthcare provider about whether lung cancer screening is right for you.