Lung Cancer Screening: What You Need to Know About Risks, Tests, and Guidelines
Lung cancer is the leading cause of cancer-related death in the United States, but early detection can significantly improve survival rates. Lung cancer screening is a powerful preventive tool that can help catch cancer before symptoms appear, when it’s most treatable. If you’re wondering whether screening is right for you, here’s what you need to know.
What Is Lung Cancer Screening?
Lung cancer screening is a preventive test used to detect signs of lung cancer in people who are at high risk but do not yet show symptoms. The test most commonly used is low-dose computed tomography (LDCT), which uses a minimal amount of radiation to create detailed images of the lungs.
Unlike diagnostic scans—which are used when symptoms like coughing up blood or chest pain appear—LDCT is used proactively to identify abnormalities before cancer develops or spreads.
Who Should Get Screened for Lung Cancer?
The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screening for adults who meet all the following criteria:
- Are 50 to 80 years old
- Have a 20 pack-year smoking history (e.g., smoking a pack a day for 20 years)
- Currently smoke or have quit within the past 15 years
This means that even former smokers may still qualify if their history places them at high risk. Individuals with a family history of lung cancer or long-term exposure to cancer-causing substances such as asbestos or radon may also be at increased risk, though current guidelines focus mainly on smoking history.
What is a pack-year?
A pack-year is calculated by multiplying the number of packs smoked per day by the number of years smoked. For example, smoking 2 packs daily for 10 years equals 20 pack-years.
How Does the LDCT Test Work?
The LDCT scan is quick, painless, and noninvasive. You lie on a table while the machine takes images of your lungs. The entire process usually takes less than 10 minutes, and there’s no need for injections or contrast dye.
Compared to traditional X-rays, LDCT is more sensitive and better at detecting small nodules or growths in the lungs at an early stage.
Benefits and Risks of Lung Cancer Screening
Primary Benefits:
- Early detection: Studies show that screening with LDCT can reduce lung cancer deaths by up to 20% in high-risk groups.
- Less invasive treatment: Catching cancer early may allow for more treatment options with fewer side effects.
- Peace of mind: For many, knowing their lung health status is empowering.
Primary Risks:
- False positives: About 1 in 4 people screened may have a result that requires further testing, even though they don’t have cancer.
- Radiation exposure: LDCT uses a low dose, but repeated scans do expose you to radiation over time.
- Overdiagnosis: In rare cases, screening may detect slow-growing cancers that wouldn’t have caused harm.
That said, for people at high risk, the benefits of screening outweigh the risks.
What Happens if My Results Are Abnormal?
If your screening shows a suspicious area, your doctor may recommend further testing, like another scan in a few months, a PET scan, or even a biopsy. But remember, an abnormal result does not necessarily mean you have cancer. Most findings turn out to be benign.
It’s also normal to feel anxious while waiting for results. Seeking mental health support during this time can be beneficial.
Insurance Coverage and Cost
Medicare covers annual lung cancer screening for eligible individuals who meet USPSTF guidelines. Most private insurance plans also cover the test as a preventive service under the Affordable Care Act.
However, eligibility documentation and pre-authorization may be required. Speak with your provider and insurer before scheduling.
When Should You Stop Getting Screened?
The USPSTF advises ending annual screening if any of the following apply:
- You turn 81
- You haven’t smoked in 15 years
- You develop a health problem that substantially limits your life expectancy or ability to undergo curative lung surgery
Common Misconceptions About Lung Cancer Screening
“I feel fine, so I don’t need a scan.” Lung cancer often doesn’t show symptoms until it’s advanced. Screening is meant for early detection, before symptoms appear.
“Only heavy smokers are at risk.” Even people with a 20-pack-year history or those exposed to secondhand smoke may be at risk. It's about cumulative exposure, not just the label “heavy smoker.”
“CT scans cause cancer.” While LDCT does involve radiation, the dose is low. The risk is minimal compared to the potential benefit of detecting cancer early.
FAQs: Common Questions About Lung Cancer Screening
Is lung cancer screening recommended for former smokers?
Yes. If you quit smoking within the past 15 years and meet the age and pack-year requirements, you are still considered at high risk and may benefit from annual screening.
What should I expect during a low-dose CT scan?
During an LDCT scan, you’ll lie on a table that moves through a circular scanner. The test is quick (about 10 minutes), painless, and doesn’t require any injections. The machine uses low levels of radiation to capture detailed images of your lungs.
How accurate is a low-dose CT scan for detecting lung cancer?
LDCT is much more effective than a standard chest X-ray in detecting early-stage lung cancers. In large trials, it has been shown to reduce lung cancer deaths by 20% among high-risk individuals.
Does lung cancer screening expose me to harmful radiation?
LDCT uses a much lower dose of radiation than a standard CT scan. The amount is similar to that of a mammogram and is considered safe for annual use in high-risk individuals.
Should I still get screened if I feel healthy and have no symptoms?
Yes. Lung cancer often develops without any symptoms in its early stages. The purpose of screening is to find cancer before it becomes advanced and harder to treat. Feeling healthy does not mean you’re risk-free if you meet the eligibility criteria.
Take Action: Is Lung Cancer Screening Right for You?
If you meet the screening criteria—or aren’t sure but have concerns about your risk—talk to your healthcare provider. Screening could save your life.
You can also take control of your broader wellness by exploring Everlywell’s at-home lab tests, which can help you monitor inflammation, toxins, and exposure to environmental risks.
How Everlywell Can Help
While low-dose CT scans for lung cancer screening must be done at a medical facility, Everlywell empowers you to take a broader approach to cancer prevention from home. If you’re a current or former smoker—or simply want to stay proactive about your health—you can now explore cutting-edge tools like the Galleri® multi-cancer early detection test, which screens for a signal shared by over 50 types of cancer through a simple blood draw.
In addition to this groundbreaking test, Everlywell offers a variety of at-home lab kits that help monitor key health indicators like inflammation, toxin exposure, cholesterol levels, and more—giving you deeper insights and empowering conversations with your provider.
Taking a proactive step today could lead to life-saving clarity tomorrow.
Explore the Galleri® test and other Everlywell solutions to support your long-term health.
References
- Centers for Disease Control and Prevention. Lung Cancer Screening. CDC.
- U.S. Preventive Services Task Force. Lung Cancer: Screening. USPSTF.
- American Cancer Society. Lung Cancer Causes, Risk Factors, and Prevention.
- Mayo Clinic. Lung Cancer Screening: What You Can Expect.
- National Cancer Institute. Lung Cancer Screening (PDQ®)–Patient Version.
- National Lung Screening Trial Research Team. Reduced lung-cancer mortality with low-dose computed tomographic screening.
- Cleveland Clinic. Lung Cancer Screening.
- Medicare.gov. Lung Cancer Screening Coverage.
- Roswell Park Comprehensive Cancer Center. Lung Cancer Screening Program.
- American Lung Association. Saved by the Scan.