Frequently Asked Questions

What is the purpose of a lung cancer screening CT?

Lung cancer screening CT is a tool for demonstrating lung nodules that may represent lung cancer. If caught early, lung cancer is more treatable. Early detection can improve your chances of living longer.

 

What is the Lung Cancer Screening Program?

If caught early, lung cancer can be cured. The Lung Cancer Screening Program uses a special type of chest X-ray called a CT scan to find early lung cancer. If you currently smoke cigarettes, the program also tries to help you stop smoking, because smoking is the number one cause of lung cancer.

 

Who should get a screening CT?

If you have all three of these risks (see below) experts recommend lung cancer screening.

  • You are 55 to 77 years old
  • You are a current or former smoker, with at least 30 pack-years of smoking
    • Pack years are determined by the number of cigarette packs per day multiplied by the number of years you smoked.
  • You are a former smoker, who quit within the past 15 years.

If you are someone who is at high risk for lung cancer, such as a current or previous heavy tobacco cigarette smoker, the importance of early detection cannot be stressed enough. Smokers with additional history of COPD, lung fibrosis, family history of lung cancer and exposure to radon, silica, cadmium, asbestos, arsenic, beryllium, chromium, diesel fumes or nickel are at higher risk.

 

When is screening recommended?

Screening looks for a disease before a person has symptoms. Screening is recommended if the person has high risk for disease, but has no symptoms of the disease.

 

What happens in the Lung Cancer Screening Program?

You will meet with a trained nurse practitioner to discuss the Lung Cancer Screening Program. You will discuss the risks and benefits of screening, then you can decide if you would like to proceed with screening.

The CT scan

  • If you decide to be screened, a CT scan of the chest will be scheduled or completed during the visit.
    • During the CT scan you will lie flat on the CT table and the machine scans over your chest during one breath hold.

It is simple, easy and does not hurt. 

  • You are encouraged to come back 1 week later to discuss the results of the CT scan and any needed follow-up plans. You will also receive a letter and a copy of your CT scan report from the radiologist. Your referring doctor will also receive a copy of the CT scan report.

  • The CT scan will be repeated every year. You will receive a reminder letter to schedule the yearly CT scan.

Smoking Cessation Counseling

  • If you currently smoke or you are trying to give up smoking the nurse practitioner will discuss ways to help you give up smoking.

  • You can have follow-up appointments to help you give up smoking.

 

What are the expectations in Lung Cancer Screening?

  • You agree to have an annual lung cancer screening CT
  • You recognize other abnormalities besides lung nodules can be found
  • You agree to have further work-up if an abnormality is found
  • You agree to pursue treatment if lung cancer is found.
 

What if you have possible symptoms of lung cancer?

Symptoms of lung cancer include:

  • A new cough
  • A change in a chronic cough
  • Coughing up blood
  • Weight loss without trying.

If you have these symptoms you will need to be seen by a pulmonary doctor.

 

How long will you be involved in the Lung Cancer Screening Program?

You will have yearly CT scans until you reach age 77 years under Medicare (or 79 years with private insurance), or it has been more than 15 years since you quit smoking.

 

What is the cost of the Lung Cancer Screening Program?

Private insurance and Medicare pay for lung cancer screening as a preventive service without a co-pay in eligible people. If the CT scan is abnormal, you or your insurance company may have to pay for additional medical tests or treatment. If you do not meet eligibility criteria for insurance coverage but have other significant risk factors, you may qualify for a lung cancer screening CT scan on a self-pay basis for $250 for each CT scan.

 

What are the consequences of getting a screening CT?

A CT scan exposes you to radiation. (see below). A lung cancer screening CT may show abnormalities that can lead to more imaging studies, medical tests, and costs to you or your insurance company.

 

Is the radiation I’m exposed to during a CT scan a concern?

We are all exposed to natural radiation in our environment. Medical imaging tests, like a screening CT scan, expose a person to slightly more radiation. This exposure is higher than background natural radiation. The amount of radiation in our lung cancer screening CT is considered safe. While there is no firm evidence that radiation from CT exams causes cancer, there is always a concern that increased radiation exposure may increase cancer risk. In the program we are constantly trying to continue to reduce everyone’s radiation exposure to the lowest possible level that will allow up to perform effective screening.

The Lung Cancer Screening CT scans at National Jewish Health are performed at the lowest dose possible and is considered to be very safe.

Learn about the Radiation Reduction Program at National Jewish Health.

 

I have a lung nodule. Is this worrisome?

  • A lung nodule is a small rounded spot on the CT scan.

  • Lung nodules are common. More than 95 out of 100 lung nodules are not cancerous, and will stay the same size, get smaller, or disappear. Some lung nodules may be an early lung cancer. A follow-up CT scan can show if the nodule is getting bigger. If a nodule gets bigger, it is more worrisome for cancer.

The goal of the Lung Cancer Screening Program is to identify lung cancer early when it is small and at a curable stage.

 

I have a suspicious lung nodule. What will happen next?

If you have a lung nodule suspicious for early lung cancer, we will contact you directly. You can be referred to one of the National Jewish Health lung specialists, or your regular doctor can help to coordinate the next steps. Further diagnostic tests may be needed such as special CT scans, a CT-guided lung biopsy, bronchoscopy or surgery.

 

What if abnormalities are found on the CT scan that are outside the lung?

The chest CTscan includes images of part of the neck with the thyroid gland, other chest organs (heart, esophagus) and part of the kidneys, pancreas, stomach and liver. Sometimes abnormalities are found in these organs that need additional testing to determine if they are serious. If you like, National Jewish Health specialists can evaluate these abnormalities with your primary care doctor.

 

This information has been reviewed and approved by Debra S. Dyer, MD (June  2016).