By Dr. Graham A. Colditz
Siteman Cancer Center
Among scary diseases, lung cancer can be one of the scariest. It is the leading cause of cancer deaths in the nation, including in Missouri and Illinois. And for smokers and many ex-smokers who are at increased risk of lung cancer, it can feel especially scary.
But there is some good news for those at high risk for the disease. Since 2013, a screening test has been available for certain heavy smokers and ex-smokers that can help catch lung cancer at earlier stages when it’s more treatable. The test is covered by Medicare and most other health insurance plans, and it’s been shown to lower the risk of dying of lung cancer by 16 percent and to lower the risk of dying of any cause by about 7 percent.
While these numbers may not sound that impressive, it’s been estimated that if everyone in the U.S. who was eligible for lung cancer screening were actually screened, it could prevent about 10,000 deaths each year, a number on par with those lost to drunk driving.
The screening test is called low-dose computed tomography, or low-dose CT. It is quick, easy and recommended for people at high risk of lung cancer. To be eligible for screening, you need to be age 55 to 77, be a smoker or ex-smoker who quit in the last 15 years and have smoked the equivalent of one pack a day or more for 30 years.
If you think you may by eligible, ask a health-care provider about screening. Together, you can decide if it’s right for you.
While a randomized clinical trial shows that the test saves lives, it does have some potential harms that are important to consider. First, low-dose CT has a relatively high false alarm rate. Officially called a false positive, this is when the test finds something that looks like cancer but isn’t cancer. False positives can make you feel anxious and stressed, and lead to follow-up tests that have their own risks.
Second, low-dose CT can lead to something called overdiagnosis. This is when the test actually finds cancer, but strange as it may seem, it’s a cancer that wouldn’t have caused any health issues if it hadn’t been found. These slow-growing cancers, nevertheless, are often still treated. And those treatments, like surgery and chemotherapy, can have risks.
Finally, there’s a small health risk from the radiation used during the low-dose CT scan itself. The amount of radiation in a single scan, though, is only about half the amount a person is exposed to during the normal course of a year.
The balance of screening’s risks and benefits can vary from person to person, and the decision to get screened is a personal one. For many people, it’s easy. For others, it can take more consideration.
There’s no right or wrong choice. But what is important is having the conversation about screening if you have a history of smoking about a pack or more a day.
Of course, the single biggest step that smokers and those who recently quit can take to protect themselves from lung cancer is to be smoke-free, whether they get screened or not. Quitting smoking for good lowers the risk of lung and many other cancers, plus heart disease, stroke and premature mortality. And it’s never too late to benefit. For help quitting, talk to your health-care provider, call 1-800-QUIT-NOW, or visit SmokeFree.gov.
It’s your health. Take control.
Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.