Lung Cancer Screenings: Here’s Why Low-Dose CT Scans are Vital for Smokers, Ex-Smokers and Others

Lung cancer remains the deadliest cancer in the U.S. and worldwide. But advances in screenings and treatments have helped raise the survival rate at more than 50 percent in the U.S.

Lung cancer is often diagnosed in later stages after it has spread. However, early detection of lung cancer through a low-dose CT scan, or LDCT, can reduce mortality for those who are or have been smokers, are 50 years of age or older, and meet the high-risk eligibility criteria. Low-dose CT scans use about one-fifth as much radiation as conventional CT scans.

More than 80 percent of lung cancer cases are caused by smoking. And while the U.S. smoking rate is at an historic low of about 11 percent, that still represents about 30 million adults who smoke, and many more millions who previously smoked and are at heightened risk of lung cancer.

Mark Dylewski, M.D., chief of general thoracic surgery at Baptist Health Miami Cancer Institute.

While screenings for lung cancer have increased due in large part to promotional campaigns – November is Lung Cancer Awareness Month – not enough people are getting screened. A report by the American Lung Association last year found that only 6 percent of eligible U.S. adults nationwide have been screened for lung cancer, and some states have screening rates as low as 1 percent.

“The unfortunate fact is that if you look at the population at risk for lung cancer, the number of individuals that get screened is very, very low,” said Mark Dylewski, M.D., chief of general thoracic surgery at Baptist Health Miami Cancer Institute. “If you look at any state, about 6 percent of any given population at risk are actually getting screened.So, it's extremely important to continue to educate high-risk patients, and to understand that this screening opportunity is available to them.”

Lung cancer is considered the most preventable cancer, with the most vital step to take to prevent it, is to quit smoking — or never start.  

The screening guidelines from the U.S. Preventive Services Task Force (USPSTF) recommend low-dose CT scans for those who have a 20-year history of heavy smoking (average of one pack of cigarettes per day), and smoke now or have quit within the past 15 years, and are between 50 and 80 years old. The American Cancer Society (ACS) this month updated its guidelines to mostly echo the USPSTF recommendations. The ACS guidelines differ by calling for smokers who quit anytime to get the yearly scans, removing the 15-year threshold.

“These guidelines will probably be flexible over time as the epidemiology of the disease is further reviewed,” said Dr. Dylewski. “And the U.S. Preventive Services Task Force is following the epidemiology of lung cancer in the U.S. The motivation that they have is to identify the highest risk factors in the largest patient population so they can guide the patients in making a decision.”

Lung cancer can be caused by risk factors other than smoking cigarettes, pipes, or cigars. Some non-smoking risk factors – representing about 10 to 20 percent of all lung cancer diagnoses -- include exposure to other people’s smoke (secondhand smoke), radon, air pollution, a family history of lung cancer, and asbestos.

“We know that when lung cancer is caught in that phase of its early growth, there's almost a zero percent chance of metastasizing,” said Dr. Dylewski. “So, if we can catch lesions in high-risk patients as early as when they're not solid, we can have a huge impact in the patient's healthcare, and also the healthcare system as a whole.”

For those who qualify for the LDCT screening program at Baptist Health Miami Cancer Institute, there’s a commitment from the Institute to guide the patient every year with follow-up appointments.

“Once you're entered as a patient in our screening program, you become a member and we reach out to you,” explains Dr. Dylewski. “We make sure that you follow up with your physician. We make sure that you follow up on your screening studies every year. And if there's any abnormality, the staff will reach out to the patient and the treating physician to make sure that they're aware that there is an abnormality.”

Lung cancer in early stages often produces no symptoms, which is why screenings are so vitally important. If you do have symptoms, they may include: Chronic cough, chest pain, shortness of breath, and recurring lung infections, such as pneumonia or bronchitis.

At Baptist Health Cancer Care, every lung cancer patient receives molecular analysis to better understand the cancer subtype, and help identify the best treatment plan using minimally invasive robotic surgery, the most precise radiation treatment available, immunotherapy and other advanced therapies.