Who Should Get a Lung Cancer Screening?

Lung screening scan recommended for at risk adults 50 and older

A patient goes over  their lung cancer screening results with their doctor.

Lung screening scan recommended for at risk adults 50 and older

Lung cancer is the leading cause of cancer-related deaths in the United States. It is a serious health problem that often doesn't show signs until it has spread, making it harder to treat in later stages.

 

The good news is that lung cancer rates are going down. This is largely because fewer people are smoking, the leading cause of lung cancer. Still, more progress is needed to catch the disease earlier and improve survival for those diagnosed.

 

“We need more at-risk people to get screened for lung cancer,” says Samir Makani, MD, an interventional pulmonologist at Scripps Cancer Center. “Lung cancer often has no symptoms until it spreads, making it harder to treat. This is why early detection through screening is so important.”

 

A low-dose CT scan is the most effective way to detect lung cancer early, when it's easier to treat. Updated lung cancer screening guidelines now allow more people — especially former smokers age 50 and older who are at high risk — to get yearly scans.

Why early detection matters

Most people with lung cancer are diagnosed in later stages. At this point, treatment is more difficult. Only about 20% of cases are found early. However, early-stage lung cancer responds better to treatment and has higher survival rates.

 

“When we wait for symptoms to appear, lung cancer is often found at an advanced stage and is harder to treat,” Dr Makani says.

Updated lung cancer screening guidelines: Who qualifies?

The United States Preventive Services Task Force (USPSTF) updated its lung cancer screening guidelines in 2021 to include more people at risk, making it possible to detect lung cancer early, when it’s most treatable.

 

You may qualify for annual LDCT scans if you:


  • Are 50 to 80 (previously 55 to 80)
  • Have a 20 pack-year smoking history (a pack year equals smoking one pack per day for one year)
  • Currently smoke or have quit within the past 15 years

 

If you meet these criteria, your doctor may recommend a yearly screening test to check for early signs of cancer — even if you feel healthy and have no symptoms.

What is a low-dose lung CT scan?

A low dose computed tomography (LDCT) is the only test recommended for lung cancer screening. LDCT uses a small amount of radiation to create detailed images of your lungs. These scans can find early warning signs, like lung nodules, which may indicate early lung cancer before symptoms appear.


The scan is:


  • Quick (only takes a few minutes)
  • Noninvasive
  • Covered by Medicare and most private health insurance if you meet screening guidelines

Scripps lung cancer screening program

To improve early detection Scripps launched the Jana Oliphant Hackett Lung Cancer Screening Program in 2022. This program supports patients who meet USPSTF lung cancer screening guidelines.

 

At Scripps, eligible patients receive:


  • A low-dose lung CT scan
  • Help with smoking cessation, if needed
  • Access to a care team, including radiologists, pulmonologists and thoracic surgeons if abnormalities are found


“We are working with our primary care doctors to raise awareness about this program. We want to help more at-risk patients get access to life-saving screenings,” Dr. Makani says.

Risk factors for lung cancer

Understanding the risk factors for lung cancer can help you and your doctor decide whether screening is right for you.


According to the American Cancer Society, about 1 in 16 men and 1 in 17 women will develop lung cancer during their lifetime. Smoking remains the leading cause, accounting for about 80% of lung cancer deaths in the United States. This includes cigarettes, menthol and “low-tar” varieties as well as cigars and pipes. The longer and more someone smokes, the greater their risk becomes.

Other causes of lung cancer

While smoking is the top risk factor, lung cancer can also affect people who have never smoked.

 

Non-smoking risk factors include:

 

  • Secondhand smoke exposure (third most common cause in the U.S.)
  • Radon gas (second leading cause in nonsmokers)
  • Asbestos
  • Air pollution
  • Radiation therapy to the chest
  • Personal history and family history
  • Workplace exposure

 

Lung cancer in nonsmokers is more common in women than in men and often develops at a younger age than in smokers.

Lung cancer prevention

You cannot eliminate all risks, but you can take steps to lower it. Quitting smoking is the single most important action you can take to protect your lungs. Avoiding secondhand smoke, testing your home for radon, using proper workplace protections and following recommended screening guidelines can also help reduce your risk.

When to talk to your doctor

If you are 50 or older and have smoked in the past, talk to your doctor about a lung cancer screening. Even if you quit years ago, you may qualify for annual screening. Many people do not know about the updated lung cancer screening guidelines.

 

If you meet the screening criteria, your doctor can refer you for a low-dose CT scan and help you take the next steps.

Watch the San Diego Health video with Dr. Makani discussing the importance of early detection of lung cancer through screening.