Who should undergo lung cancer screening?

People who are between 55-80 years of age, who have smoked at least 1 pack per day for 30 years, or current smokers or former smokers who quit smoking within the last 15 years should ungergo lung cancer screening.

Does the CT scan diagnose lung cancer?

Between 3% and 51% of the CT scans will show a mass in the lung. Of the people with a mass in the lung, between 1% and 5% have cancer.

Who should review the CT scan with you?

The CT scan should be reviewed by a radiologist with special expertise in evaluating lung masses or a specialist (e.g. a thoracic surgeon) who frequently evaluates screening CT scans with masses. Because <5% of masses found by screening are cancer, an expert is needed to determine which nodules to follow and which to diagnosis or treat.

What happens during a screening visit?

A lung cancer screening specialist will prepare you for what to expect from the screening. Then you will undergo a low-dose chest CT scan. After the scan, you will receive the results from your lung cancer screening specialist. You may also want to discuss your results with your physician or qualified nurse practitioner. Our team will let your doctor know your results, so he or she can recommend next steps if needed.

Who pays for the screening CT?

A screening CT for lung cancer is covered by Medicare and most insurance companies, such as Blue Cross, Blue Shield, Aetna, and United Health Care. You can call the phone number on the back of your health insurance card to make sure that your insurance carrier covers lung cancer screening. The scan can be scheduled by calling (310) 829-8686.

CT Lung Cancer Screening - Saint John’s Cancer Institute

Lung Cancer Screening and Early Detection

Lung cancer screening uses a low-dose CT (LDCT) scan to look for lung cancer in people who are at increased risk but do not have symptoms. Detecting lung cancer at an earlier stage can increase treatment options and improve the chance of successful treatment.

Screening is recommended for many people with a significant history of cigarette smoking, including some who quit years ago. Eligibility depends on age, smoking history, overall health, and the screening guideline or insurance coverage being used. A healthcare professional can help determine whether annual lung cancer screening is appropriate for you.

Does Lung Cancer Screening Work?

Lung cancer screening at Saint John's Health Center — Low-dose CT screening can detect lung cancer at an earlier stage in people who are at increased risk.

Yes. Large clinical trials have shown that screening people at increased risk with low-dose CT can reduce the likelihood of dying from lung cancer compared with chest X-ray screening or no screening. Low-dose CT can identify small lung nodules that may not be visible on a standard chest X-ray.

The goal of screening is to find lung cancer before it causes symptoms, when the disease may be smaller and more treatable. Screening does not prevent lung cancer and does not guarantee that every cancer will be detected, but for people who meet recommended criteria, the benefits can outweigh the potential risks.

Who Should Consider Lung Cancer Screening?

Current recommendations generally focus on adults with a significant history of cigarette smoking who are otherwise healthy enough to undergo additional evaluation and treatment if a cancer is found.

Current Screening Recommendations

The U.S. Preventive Services Task Force recommends annual low-dose CT screening for adults ages 50 to 80 who have at least a 20 pack-year smoking history and currently smoke or quit within the past 15 years.

The American Cancer Society also recommends annual screening for adults ages 50 to 80 with at least a 20 pack-year smoking history who currently smoke or previously smoked. Its current guideline does not use the number of years since quitting as an eligibility requirement.

Medicare coverage has its own requirements, including age and smoking-history criteria. Because recommendations and insurance coverage are not identical, our screening team can help determine which criteria apply to you.

What Is a Pack-Year?

A pack-year is a way of describing how much a person has smoked over time. One pack-year is equal to smoking one pack of cigarettes per day for one year.

1 pack per day for 20 years = 20 pack-years
2 packs per day for 10 years = 20 pack-years
½ pack per day for 40 years = 20 pack-years

Screening Is for People Without Symptoms

Lung cancer screening is intended for people at increased risk who do not currently have signs or symptoms of lung cancer. If you have a persistent or worsening cough, cough up blood, develop unexplained weight loss, chest pain, shortness of breath, or another concerning symptom, you should speak with a healthcare professional about diagnostic evaluation rather than wait for a screening examination.

What Is the Lung Cancer Screening Test?

Low-dose computed tomography, or LDCT, is the recommended screening test for lung cancer. The scan uses X-rays and computer technology to create detailed images of the lungs while using substantially less radiation than a standard diagnostic chest CT.

The examination is quick, painless, and does not require surgery. LDCT can identify very small lung nodules, but finding a nodule does not mean that a person has lung cancer. Most nodules detected during screening are not cancerous and can often be safely monitored with follow-up imaging.

How Screening Results Are Evaluated

Radiologists evaluate the size, appearance, and growth of any lung nodules found on the scan. Screening programs can use standardized reporting systems such as Lung-RADS to help determine whether a finding appears benign, should be monitored with another scan, or needs additional evaluation.

When follow-up is recommended, the next step may be another CT scan after a specified period of time or, for more suspicious findings, additional imaging or consultation with a pulmonary or thoracic specialist. Most screening findings do not require an immediate biopsy or procedure.

What Happens During Lung Cancer Screening?

Healthcare specialist discussing lung cancer screening with a patient — A healthcare professional can review your risk, explain lung cancer screening, and discuss what your results mean.

Lung cancer screening is designed to be straightforward. Before your first scan, your healthcare team reviews your eligibility and discusses the benefits and limitations of screening. The CT itself generally takes only a short time.

Review your screening eligibility. Your age, smoking history, health, and other factors are reviewed.
Discuss screening. Your healthcare professional explains the potential benefits, limitations, and possible follow-up testing.
Complete the low-dose CT scan. You lie on a table while the scanner creates detailed images of your lungs.
Receive your results. A radiologist interprets the scan and the screening team communicates the findings.
Follow the recommended next step. Depending on the result, this may be annual screening, an earlier follow-up CT, or additional evaluation.

Who Reviews the Screening CT?

Lung cancer screening CT scans are interpreted by radiologists trained in chest imaging and the evaluation of lung nodules. When a finding requires additional attention, pulmonologists, thoracic surgeons, oncologists, and other specialists may become involved so that the next step is based on the characteristics of the nodule and the patient’s individual risk.

Will Insurance Cover Lung Cancer Screening?

Medicare and many private health plans cover annual low-dose CT lung cancer screening for people who meet their coverage criteria. Because eligibility and coverage requirements can differ among insurers, patients should confirm benefits with their health plan and screening program.

To learn more about scheduling lung cancer screening at Saint John’s Health Center, call (310) 829-8686.

What to Expect During Lung Cancer Screening

A low-dose CT (LDCT) lung cancer screening is a quick, painless, and noninvasive examination. The scan creates detailed images of the lungs using a lower dose of radiation than a standard diagnostic chest CT and does not typically require contrast dye, an injection, or anything to swallow.

The CT scan itself usually takes only a few minutes, although additional time is needed for registration, preparation, and other parts of the appointment. Your screening team will provide any instructions you need before the examination.

Getting Your Low-Dose CT Scan

For the scan, you will lie on your back on the CT table, usually with your arms positioned above your head. The table moves through the open center of the scanner while detailed images of your lungs are created.

You will need to remain still and may be asked to hold your breath briefly while the images are taken. A technologist operates the scanner from an adjoining area and can see, hear, and communicate with you throughout the examination.

After Your Lung Cancer Screening

After the examination, a radiologist reviews the images for lung nodules and other findings. Many lung nodules are benign, meaning they are not cancer, and do not require an immediate procedure or biopsy.

The size, appearance, and any change in a lung nodule over time help determine what happens next. Depending on the findings, the recommendation may be to continue annual screening, repeat the CT sooner to monitor a nodule, or perform additional evaluation.

Getting Your Screening Results

Your screening team will communicate your results and explain any recommended follow-up. If a finding needs additional evaluation, you may be referred to a pulmonologist, thoracic surgeon, or another specialist for further assessment.

An abnormal screening result does not necessarily mean that lung cancer has been found. When appropriate, follow-up imaging can determine whether a nodule remains stable or changes over time, helping physicians avoid unnecessary procedures while identifying findings that require closer evaluation.

How Accurate Is Low-Dose CT Lung Cancer Screening?

Low-dose CT is much more sensitive than a standard chest X-ray for detecting small lung nodules and is the recommended imaging test for lung cancer screening in people who meet screening criteria. Large clinical trials have shown that screening people at increased risk with LDCT can reduce deaths from lung cancer.

However, a CT scan cannot always determine whether a lung nodule is cancerous simply from its appearance. Screening can identify abnormalities that ultimately prove to be benign, and some findings require additional imaging to determine whether they are stable or changing.

What Happens if a Lung Nodule Is Found?

Finding a lung nodule is relatively common and does not mean that you have lung cancer. Physicians consider factors such as the nodule’s size, shape, appearance, growth, and your individual risk when deciding what should happen next.

Many nodules can be safely monitored with another CT scan after a recommended period of time. Nodules that appear more suspicious may require additional imaging or evaluation by a pulmonary or thoracic specialist. In selected cases, a biopsy may be recommended to determine whether cancer is present.

Why Follow-Up Matters

Lung cancer screening works best as an ongoing program rather than a single CT scan. Following the recommended screening or surveillance schedule allows radiologists to compare images over time and identify changes that may require further evaluation.

If your screening result recommends another scan or additional evaluation, completing that follow-up is an important part of the screening process.

How Often Should You Be Screened for Lung Cancer?

For people who meet screening criteria, lung cancer screening is generally performed once each year with low-dose CT. Continued screening depends on factors such as age, smoking history, overall health, and the guideline being followed.

Screening recommendations may change over time, and organizations do not currently use identical eligibility criteria. Your healthcare professional or lung cancer screening team can help determine whether you should continue annual screening based on current recommendations and your individual circumstances.

If a screening scan identifies a lung nodule that needs closer monitoring, your next CT may be recommended sooner than one year. This is considered follow-up of a screening finding rather than the routine annual screening schedule.

Can a Blood Test Screen for Lung Cancer?

Currently, a blood test does not replace low-dose CT for routine lung cancer screening. Researchers are studying blood-based tests that look for cancer-related signals, including circulating tumor DNA and other biomarkers, but LDCT remains the established screening test for people who meet recommended criteria.

Blood-based molecular testing can have an important role after lung cancer has been diagnosed, particularly when physicians are looking for genetic and molecular changes that may help guide treatment. That is different from using a blood test to screen a person without symptoms for lung cancer.

Steps to Help You Quit Smoking

Quitting smoking is one of the most important things you can do to improve your health and reduce your risk of lung cancer, heart disease, and other smoking-related conditions. The benefits begin after you stop smoking and continue to increase over time, regardless of how long you have smoked.

Nicotine is highly addictive, so quitting can be difficult. Proven treatments are available, and you do not have to rely on willpower alone. Combining counseling and support with medications to help manage nicotine cravings and withdrawal can provide the best chance of quitting successfully.

Make a Plan to Quit

Choosing a quit date and making a plan can help you prepare for situations in which you would normally smoke. Consider your reasons for quitting, when and where you are most likely to smoke, and what you can do differently when cravings occur.

Removing cigarettes, ashtrays, lighters, and other reminders of smoking from your home, car, or workplace can also make it easier to begin changing established routines.

Know Your Smoking Triggers

Certain situations, emotions, activities, or routines can trigger the urge to smoke. Common triggers may include stress, alcohol, driving, finishing a meal, taking a work break, or spending time around other people who smoke.

Identifying these patterns ahead of time allows you to plan alternatives. Taking a walk, changing a routine, practicing relaxation techniques, calling someone for support, or using an appropriate quit-smoking medication can help you manage cravings when they occur.

Use Support to Help You Quit

Support can make quitting easier. Family and friends can encourage you and help you avoid situations that make smoking more difficult to resist. Professional counseling can provide additional strategies for managing cravings, stress, and changes in routine.

Support is available through healthcare professionals, individual or group counseling, telephone quitlines, and online or text-based programs. Free confidential coaching is also available by calling 1-800-QUIT-NOW.

Consider Medications That Can Help

Medications can reduce nicotine withdrawal symptoms and cravings and improve the likelihood of successfully quitting. Nicotine replacement therapy is available in several forms, including patches, gum, and lozenges, while other quit-smoking medications are available by prescription.

For some people, combining a nicotine patch with a shorter-acting form of nicotine replacement, such as gum or a lozenge, can be more effective than using one form alone. Prescription medications such as varenicline or bupropion may also be appropriate. A healthcare professional can help you choose an approach based on your health, preferences, and previous experiences with quitting.

Prepare for Cravings and Withdrawal

Cravings, irritability, restlessness, difficulty concentrating, and changes in sleep or mood can occur as the body adjusts to being without nicotine. These symptoms generally improve with time, and medications and behavioral strategies can make them easier to manage.

Having a plan before a craving occurs can help. Remind yourself why you decided to quit, change what you are doing, use your quit-smoking medication as directed, or reach out to someone who supports your goal.

If You Start Smoking Again, Keep Going

Many people make more than one attempt before they stop smoking permanently. Smoking a cigarette or returning to smoking does not mean that your efforts have failed. It can help identify situations or triggers that need a different strategy the next time.

Talk with your healthcare professional or quit-smoking counselor about what happened and whether another approach, medication, or combination of treatments could help. Each attempt can provide useful information for building a quit plan that works for you.

If you have questions regarding Lung Cancer Screening, please call today. Click here to request a screening appointment.

855-306-9700

More from our Blog

Dr. Richard Gillespie - Lung Cancer Screening and Awareness

Early Detection Saves Lives: A Thoracic Surgeon’s Message for Lung Cancer Awareness Month

Dr. George Chaux Welcomes Dr. Richard Gillespie to Saint John's

Advancing Lung Cancer Care at Providence Saint John’s Health Center

Pulmonary Team at Saint John's Health Center

Saint John’s Pulmonary Team Expands Lung Cancer Screening Capability, Offers Disaster Relief Clinic

Dr. George Chaux - Ion robot bronchoscopy using Cios Spin C-arm 3D Imaging

CT Lung Cancer Screening