Lung Cancer Screening FAQs

  • If you are at risk of lung cancer, you may want to have low-dose CT scan that can help detect lung cancer at its earliest and most curable stage.  The best hope for curing lung cancer is finding it as early as possible.  The Early Lung Cancer Action Program (ELCAP research showed that annual CT screening can find 85% of lung cancers in their earliest, most curable stage (Lancet 1999; 354:99-105). A CT scan can detect tiny spots on your lungs (called ‘nodules’) that may indicate lung cancer in this early stage (New England Journal of Medicine 2006; 355: 1763-1771).  The ELCAP research results together with the National Lung Screening Trial (NLST) (New England Journal of Medicine 2011; 365:395-409) results led to the current recommended program of clinical screening.

  • Advances in CT scanning now allow individuals to undergo a painless, non-invasive scan that takes less than 20 seconds.  In most cases, you do not even have to change your clothes.

    Prior to scanning, you should fill out our simple questionnaire that can be completed in less than half an hour.  A trained healthcare navigator will assist you throughout the process.

  • A radiologist who has had special training and is experienced in interpreting these types of tests analyzes each CT scan.

    The radiologists will discuss any findings and necessary follow-up with the participant's physician.

  • Lung cancer results in more deaths in the United States than any other cancer; in fact, it accounts for more deaths than breast, cervix, colon, and prostate cancer combined.

    Because lung cancer has no symptoms in its early stages, more than 85 percent of the men and women who are diagnosed with lung cancer today are diagnosed in a late stage, after symptoms occur and when there is very little chance of cure. As a result, approximately 95% of the 173,000 people diagnosed each year die from the disease.

    With early detection, 85 percent of cancers can be found in the earliest, most curable stage.  If treated promptly with surgery, their cure rate is 92% (New England Journal of Medicine 2006: 355: 1763-1771).

     

  • The latest research from I-ELCAP shows that patients diagnosed with lung cancer as a result of annual CT screening have an overall cure rate of 80%, regardless of stage and type of treatment. When cancers are found at the earliest stage (85% of the patients) and are immediately removed with surgery, the research shows a cure rate of 92%. The research involves over 31,000 patients who are considered to be at risk for lung cancer due to a combination of their age and histories of cigarette smoking, occupational exposure to carcinogens, or exposure to second-hand smoke (New England Journal of Medicine 2006: 355: 1763-1771).

    The initial findings of the ELCAP team, published in The Lancet, a prestigious medical journal, as summarized on the front page of The New York Times, showed that chest x-rays done at the same time as the CT scan failed to reveal 85% of the early-stage cancers detected by the CT scans. The ELCAP team also developed procedures and analytic techniques for highly accurate assessment of tumor growth, significantly reducing the chances of unnecessary additional tests and treatments.

  • Each participating I-ELCAP institution has their own eligibility criteria and these are available by calling the institution.  Contact information is in the Screening Sites section.

     

  • Each institution charges for the screening CT scan, with most United States facilities charging between $100 and $400. If you meet the Medicare and Medicaid Services requirements of age and smoking then the screening is provided at no cost to you.  Some locations also provide free CT scans to participants if the facility has a funded research program for people who do not meet the criteria for a free scan.  If a positive or questionable finding is seen and follow-up procedures are required (such as a diagnostic CT scan or biopsy), the participant is responsible for the costs either through insurance or self-payment.

  • CT screening uses a lower dose compared to standard CT scans. We strive to keep the dose between 1-2 mSv (millisieverts) or lower, although for individual patients it may be slightly higher than this value. As a comparison, average background radiation in the US is approximately 3 mSv/ year and in Denver, Colorado, due to the higher altitude it is 11.8.  Another comparison is that the exposure of a low-dose CT scan is less than a mammogram which is below 0.6 mSv.

  • Each participant, with guidance from the healthcare navigator, will be asked to fill out a confidential questionnaire on smoking habits and other relevant risk factors for lung cancer.  This information is important to the radiologist reading the CT scan. The participant also signs a standard CT scan consent form.  It reminds each participant to return for the next annual screening, one year after the prior screening.  This is very important as it is these repeated annual screenings that truly save lives.

  • In communities of color--which traditionally have limited access to health care information, diagnostic procedures, and medical treatment--lung cancer kills at disproportionately higher rates. The disease accounts for 25% of all cancers diagnosed in African American men; this is almost double the rate of lung cancer deaths for the overall US population. The lung cancer mortality rate for African American men is more 46% higher than that of white men.  Cancer death rates among African American women are 20% higher than among white women.

    Unfortunately, less data are available on Hispanic men and women.  The American Lung Association recently reported that "smoking behaviors and lung cancer rates differ among different segments of the Hispanic population, and closer examination is needed to get a more accurate picture of each group."

  • A chest x-ray shows only two views of your chest (front and side), while a CT scan shows cross-sectional images all through your chest-from the very top of your lungs through the lung bottom.  Thus, tiny abnormalities (that could be early stage lung cancer) can be found which would never have been seen on a chest x-ray.

  • Yes. Old or new pneumonia, tuberculosis, or emphysema may be detected.

     

  • A limited evaluation will be done. The radiologists are able to see heart size and can detect calcifications in the coronary arteries when present. It also can detect abnormal enlargements of the main blood vessels leading out of the heart. These results will be reported to your doctor.

  • The benefits of lung cancer screening CT scans are highest for those with significant lung cancer risk.

    ELCAP and its expanded research collaboration, the International ()I-ELCAP has focused on patients at a high risk for lung cancer. Several factors contribute to lung cancer risk.  They are age; smoking history; environmental exposure to carcinogens like asbestos, beryllium, uranium, or radon; and exposure to second hand smoke. The older you are and the more you've smoked or been exposed to smoke and other carcinogens, the higher your risk.

    Additionally, I-ELCAP research has shown that women were twice as likely as men to develop lung cancer when both had similar smoking histories. Click here for more information about how lung cancer affects women.

    We encourage you to contact one of our member sites to make an appointment and learn more about how you personally may benefit from a lung cancer screening CT.

  • Risks associated with being screened include finding abnormalities that need additional tests and that are ultimately benign. These tests can cause anxiety and on some occasions lead to invasive procedures such as biopsy to further determine whether a finding is a cancer. The I-ELCAP protocol has been frequently updated with the latest knowledge and advances to keep these risks at a minimum. This should be discussed with your doctor for further information.

  • If you are interested in being screened, we recommend that you discuss the risks and benefits with your doctor so that it is a shared decision. If you do decide to undergo screening, please call the coordinator at your nearest member institution. We ask that you be prepared to give the following information:

    • Your name, address, phone number, birth date, and parent’s first names for registration purposes.
    • A time convenient for you to schedule an appointment.
  • The times will vary from site to site.  Currently, most sites offer some evening and weekend appointment in addition to daytime slots.

     

  • The actual CT scan takes only about 5 minutes in total (with set up and scanning time). The scan itself only takes seconds.  The registration and interview with the navigator/coordinator may add an additional 25-30 minutes to your visit.  We recommend setting aside one hour of your schedule for this appointment, even though it is unlikely that the entire hour will be necessary.

  • Medicare and Medicaid Services provides free annual screenings to men and women who are 55 to 77 years old and have smoked at least 30 pack-years and are either currently smoking or quit smoking less than 15 years ago.