Should You Get Screened for Lung Cancer?

Lung cancer is among the most common cancers in the United States, and it is one of the most deadly. The American Cancer Society estimates 234,580 will be diagnosed with lung cancer this year, and more than 125,000 people with die as a result of it.

Cigarette smoking is linked to the vast majority of lung cancer deaths – and even if you have quit, you still may be at risk.

But like many cancers, early detection is key to better outcomes. The American Cancer Society recommends that people aged 50 to 80 who smoke or formerly smoked or have a 20-year or greater “pack-year” history receive an annual chest CT scan to screen for lung cancer.

We asked radiologist Mary Salvatore, MD, a specialist at Columbia’s Herbert Irving Comprehensive Cancer Center, how the scan works, what information in provides doctors, and why lung cancer screening is important.

She’s a former smoker who helped start Columbia’s Lung Cancer Screening Program. Here’s what she said.

How does lung cancer screening work?

Doctors perform a low-dose CT scan of a patient’s chest to look for regions in their lungs that might be cancerous. We say “low-dose” because we use a lower dose of radiation than we would for a normal CT scan to reduce the amount of radiation a patient receives. Doing this allows us to get a good picture of what’s happening in the lungs while still minimizing the risk from screening on an annual basis.

Who should be screened for lung cancer?

According to the American Cancer Society, anyone aged 50 to 80 who smokes or formerly smoked or has a 20-year or greater “pack-year” history of smoking should be screened.

Many people outside of this group should be screened, including those exposed to extensive secondhand smoke. This group is also vulnerable to lung cancer and should be screened.

Also, I recommend that anyone who has fibrosis should be screened for lung cancer every year. My work is in pulmonary fibrosis, which has a higher risk for developing lung cancer than emphysema, yet currently, it is not included as a reason for screening.

Can you reduce lung cancer risk after you’ve started smoking?

Yes. Quitting smoking at any point is better than continuing because your risk of lung cancer immediately starts to go down. The best thing you can do for your health is to stop smoking whenever you can. It’s a great feeling to be able to stop smoking.

If you’re trying to get a loved one to quit, screening is a good first step. We see people who have a normal test (no sign of lung cancer) who say: “Thank goodness! I’ll stop smoking now so I don’t do more damage.” We also see people who have an abnormal test (signs of lung cancer) who are terrified and want to stop immediately. Either way, getting screened for lung cancer is a very powerful motivator.

You helped launch Columbia’s Lung Cancer Screening Program in 2022. How is it going?

The program has quickly grown in leaps and bounds. We went from an average of 8 referrals a month to nearly 70 referrals a month to screen people for lung cancer. Our success is truly gratifying, knowing how many people we can help.

How does being a former smoker inform your work?

In the 1980s, everybody was smoking. It was a different world. When I had my children, I stopped because I did not want to expose them to secondhand smoke. I was surprised at how easy it was to quit smoking compared to what I had heard.

Now, when I meet with patients, I share my quitting story. It can be helpful to talk to someone who successfully stopped smoking. Many of my patients stop after considering their screening and hearing me say it wasn’t that hard to quit.

Most smokers feel embarrassed to smoke when we all know how terrible it is for our health, so it’s liberating when you can kick the habit. It makes you feel very successful.