New Lung Cancer Screening Reduces Deaths Through Early Detection

New screening technologies are being used to help identify potential health issues earlier in patients who may be at risk of contracting certain cancers.

Symptoms of lung cancer usually don’t appear until the disease is already at an advanced, non-curable stage. Even if there are symptoms, many people may mistake them for other problems, such as an infection or long-term effects from smoking.

Screening is the use of tests or exams to find a disease in people who don’t have symptoms. Doctors have looked for many years for a good screening test for lung cancer, but only in recent years has research shown that a test known as a low-dose CT (LDCT) scan can help lower the risk of dying from this disease.

The National Lung Screening Trial (NLST) was a large clinical trial that looked at using LDCT scans of the chest to screen for lung cancer. CT scans of the chest provide more detailed pictures than chest x-rays and are better at finding small abnormal areas in the lungs. Low-dose CT of the chest uses lower amounts of radiation than a standard chest CT and does not require the use of intravenous (IV) contrast dye. LDCTs expose people to a small amount of radiation with each test.

The trial compared LDCT of the chest to x-rays in people at high risk of lung cancer to see if these scans could help lower the risk of dying from lung cancer. The study included more than 50,000 people aged 55 to 74 who were current or former smokers and were in fairly good health. The study did not include people if they had a prior history of lung cancer or lung cancer symptoms, if they had part of a lung removed, if they needed to be on oxygen at home to help them breathe, or if they had other serious medical problems.

People in the study got either three LDCT scans or three chest x-rays, each a year apart, to look for abnormal areas in the lungs that might be cancer. After several years, the study found that people who got LDCT had a 20 percent lower chance of dying from lung cancer than those who got chest x-rays. They were also 7 percent less likely to die overall (from any cause) than those who got chest x-rays.

Screening with LDCT also had some downsides. For example, because it is more sensitive to abnormalities (as many as one in four tests) this may lead to additional tests such as other CT scans or more invasive tests such as needle biopsies or even surgery to remove a portion of lung in some people. These tests can sometimes lead to complications, even in people who do not have cancer (or who have very early stage cancer).

Guidelines for lung cancer screening

The cost for a low-dose CT scan as a screening test for lung cancer is generally about $300 for each test, but prices vary widely at different centers. Under the Affordable Care Act, most private insurers must cover the cost of yearly lung cancer screening in people considered at high risk: aged 55 to 80, with a 30 pack-year history of smoking, and either a current smoker or quit within the last 15 years. Medicare also covers the cost of lung cancer screening in people considered at high risk, although the age range is slightly different (55 to 77 years).

According to the American Cancer Society, people who meet all of the following criteria may be good candidates for lung cancer screening:

  • 55 to 74 years old
  • In fairly good health
  • Have at least a 30 pack-year smoking history
  • Are either still smoking or have quit smoking within the last 15 years

Screening should only be done at facilities that have the right type of CT scanner and experience using LDCT scans for lung cancer screening.

If you fit all of the criteria, you should talk to your doctor or health care provider about screening and if it’s right for you. If you smoke, you should consider counseling about stopping. Screening is not a good alternative to stopping smoking, but it’s one more way you can take a more active role in helping to prevent or potentially reduce the risk of contracting a serious disease like lung cancer.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!