Screening For Lung Cancer: Should I Do It?
Dear Dr. Mahler:
I am 64 years old and my new physician’s assistant recommended a CT scan to screen for lung cancer. Does this make sense? I take two different inhalers in the morning for my COPD and use albuterol puffer at least once most days. Each winter I seem to get a chest infection that requires an antibtiotic and a course of prednisone. There is a family history of stomach cancer, but no lung cancer as far as I know. Thanks. By the way, I quit smoking five years ago.
Mark from Kokalakis, MI
Dear Mark:
Screening means testing for a disease when a person has no symptoms or history of that disease. A screening test is recommended to find a disease early when treatment may work better. The only recommended screeening test for lung cancer is low-dose computed tomography (LDCT).
Lung cancer screening
The United States Preventive Services Task Force recommends yearly lung cancer screening with LDCT for those who: [1] have smoked at least 20 pack-years (the same as smoking one pack per day for 20 years); AND [2] are current smokers or have quit smoking within the past 15 years; AND [3] are between 50 and 80 years of age
When Should Screening For Lung Cancer Stop?
The task force recommends that yearly lung cancer screening stop when the person turns 81 years of age, or has not smoked for 15 or more years, or has devleoped a health problem that makes her or him unwilling or unable to have surgery if lung cancer is found.
More information on screening for lung cancer can be found on the CDC website
Blood Test May Identify Lung Cancer Earlier
Despite screening for lung cancer being “standard of care,” only 5 – 20% of eligible individuals actually get LDCT screening. Ot these, fewer than 40% continue with annual scans. Researchers at the Cleveland Clinic, in partnership with DELFI Diagnostics, have developed a blood test to screen for lung cancer. The test identifies amounts and sizes of DNA fragments in the blood as those who have lung cancer have more varied fragments compared with those who do not have lung cancer. At the present time, investigators at the Cleveland Clinic have a training grant to evaluate this blood test.
COPD And Lung Cancer
The Lung Health Study showed that of 5,800 indiviudals with mild to moderate COPD, lung cancer accounted for 33% and heart disease for 22% of all deaths. Cigarette smoking is the presumed link that contributes to lung cancer and COPD.
Mark – based on the information that you provided, it makes sense to go ahead and have the LDCT to screen for lung cancer. Please understand that a CT scan can provide additional information including whether there is evidence of emphysema and whether you have calcification of the coronary arteries (in the heart) which may suggest narrowing of these blood vessles.
Please note, the advice provided is not a substitute for asking your health care professional about your specific situation.
Sincerely,
Donald A. Mahler, M.D.