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Cancer
Tuesday Q and A: Lung cancer screening used to find cancer at an early stage
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DEAR MAYO CLINIC: At my last physical, my doctor suggested that I should be screened for lung cancer. I used to smoke about a pack of cigarettes a day, but I quit 12 years ago. I am 63 now and in good health. Is screening really necessary for me? What does it involve?
ANSWER: Screening programs are used to find lung cancer at an early stage, when it is more likely to be successfully treated. In general, screening is recommended for people at higher risk of developing lung cancer. That often includes people like you who smoked heavily at some point in their lives.
Lung cancer is currently the number one cancer killer in the United States. More people die in the U.S. each year from lung cancer than from colon, breast and prostate cancer combined. But studies have shown that a properly organized screening program can reduce the number of people who die from lung cancer by 20 percent.
In particular, a research study called the National Lung Screening Trial found that three specific segments of the population benefit the most from screening. The first group includes people who have had lung cancer before. The second group is people who smoked a pack of cigarettes a day or more for 30 years or longer.
The third group includes people who smoked a pack a day or more for 20 years or longer and who also have another factor that raises their risk of lung cancer. Those factors may include a family history of lung cancer; having emphysema or another lung disorder; having undergone radiation treatment; or a previous cancer diagnosis in another part of the body.
Lung cancer screening programs use an imaging exam called low-dose computerized tomography, or CT, scan of the lungs to look for lung cancer. Getting a CT scan involves a medical appointment that lasts about an hour, although the actual scan usually takes less than a minute. A low-dose CT scan is a painless procedure, similar to getting an X-ray. The detailed images of the lungs and surrounding structures created during the scan are generated by a computer and reviewed by a radiologist — a doctor who specializes in diagnosing conditions with imaging tests.
Using CT scans to screen for lung cancer is important because these scans can reveal lung cancers long before they cause symptoms or show up on a chest X-ray. A CT scan can spot cancers as small as a grain of rice. That is significant because survival after lung cancer treatment is directly related to the stage at which the cancer is first found.
When lung cancer is identified at a very early stage with a screening CT scan, the cancer often can be cured with surgery. In addition, treatment for early stage lung cancer often can be done using minimally-invasive techniques. After minimally-invasive surgery, people typically recover more quickly and return to their usual activities sooner than they would with more invasive surgical approaches.
Quitting smoking was an excellent decision — perhaps the best health care decision you will make in your life. Stopping smoking dramatically lowers the risk for many health problems and increases overall health and well-being. Getting screened for lung cancer simply reinforces that decision by continuing to help protect your health, now and into the future. — Stephen Cassivi, M.D., Thoracic Surgery, Mayo Clinic, Rochester, Minn.
