Should You Get Screened for Lung Cancer?

Robert Smith, lead author on the ACS guidelines and senior vice president of early cancer detection science at the cancer society, said the 2023 change was based on recent studies that “have shown extending the screening age for persons who smoke and formerly smoked, eliminating the ‘years since quitting’ requirement and lowering the pack per year recommendation could make a real difference in saving lives.”

Broadening the eligibility criteria will also help to “include more women and minorities, who typically smoke fewer cigarettes daily,” says Dr. Maher A. Karam Hage, professor of behavioral science at the University of Texas MD Anderson Cancer Center.

“Reducing the age and pack-year requirements allows them to qualify sooner, potentially leading to earlier detection of any suspicious nodules or masses,” he told AARP in an email.

Pack-year is a measure used to describe how many cigarettes a person smoked and for how long. For example, a person would have a 20 pack-year history if they smoked one pack a day for 20 years, or two packs a day for 10 years. 

“If you’re aged 50 to 80 and have ever smoked, talk to your doctor to find out if you’re eligible for lung cancer screening and whether it would be appropriate for you,” Bandi said. “Also, expanding current screening eligibility irrespective of years since quitting is warranted and could help save lives.”

Early detection is key to saving lives

Lung cancer is the deadliest cancer in the U.S., according to the National Cancer Institute.

It can occur in anyone at any age. But cigarette smoking is the top risk factor and is linked to about 80 to 90 percent of lung cancer deaths, and most people diagnosed with the disease are 65 or older.

What makes lung cancer especially tricky is that it’s often symptomless until it’s at an advanced stage, when it’s harder to treat. Karam Hage says that in large-scale trials, early detection can lead to a 20 to 25 percent improvement in survival rates, resulting in fewer deaths from this cancer.

The ACS’s Smith says that while lung cancer cases and deaths continue to drop due to fewer people smoking and advances in treatment, “we still have to do better.” The update in the guidelines “is a step in the right direction,” he adds.

Eligible? Talk to your doctor

If you’re eligible for lung cancer screening, start by speaking with your primary care physician, Karam Hage says — even if it’s been a long time since you smoked.

“Traditionally, it was believed that after 15 years of no smoking, the risk of lung cancer decreases to a point that screening is no longer cost-effective. However, new data suggests that while the risk of lung cancer in former smokers goes down, the risk of malignancies from aging increases,” Karam Hage says. 

Medicare Part B will cover lung cancer screenings with a low-dose CT scan once a year for people ages 50 to 77 who are current smokers or quit in the past 15 years and have a 20-pack-year history. Patients must have an order from their doctor or health care provider and should not have symptoms of lung cancer. People with private insurance should check with their plan provider about coverage eligibility and potential out-of-pocket costs.

A low-dose CT scan is a noninvasive test where you lie down and hold your breath while being moved through a doughnut-shaped X-ray machine, according to the U.S. Centers for Disease Control and Prevention (CDC). The scan takes several X-ray images of the lungs and can help identify possible abnormalities in the lung tissue.

There are some potential risks with this screening, including the possibility of false positives, which can lead to more scans or invasive procedures, Karam Hage says. About 12 to 14 percent of lung cancer screening scans will have a false positive, about the same rate as with mammograms, according to the American Lung Association.

“It’s essential to weigh these risks against the benefits, and, in my opinion, the advantages outweigh potential drawbacks,” Karam Hage says.