Low Dose CT Lung Cancer Screening

Patient Education

1.  What are the facts about lung cancer?

  • Leading cause of cancer death in the US
  • Cured with surgery if detected early
  • Most people do not have any symptoms and therefore most lung cancers are detected at an advanced stage, when they are no longer eligible for surgery

2.  What is cancer screening?

  • Screening is to detect disease in a person before they develop symptoms.  The goal is to catch cancer early so there is a chance for cure.

3.  What is lung cancer screening (LCS)?

  • LCS is a multidisciplinary program to detect early stage lung cancers that can be cured by surgery using low dose chest CT
  • A national study found a 20% reduction in lung cancer death using low dose chest CT
  • Quitting the use of cigarette smoking is the most important tool to prevent lung cancer

4.  What is a low dose CT lung cancer screen?

  • CT stands for Computed Tomography. Computed Tomography is an imaging procedure that uses special x-ray equipment to create detailed pictures or scans of areas inside the body. CT images of internal organs, bones, soft tissue and blood vessels typically provide greater detail than traditional x-rays.

5.  Who is eligible? 

Anyone who has all 3 of:

  • Age 55-77
  • Smoke(d) for a minimum of 30 pack years (# of pack years = number of packs per day x number of years smoked)
  • A current smoker or quit smoking less than 15 years ago

6.  Who should not be screened?

  • If you are unwilling to have treatment for lung cancer if detected
  • If you are too sick to tolerate surgery
  • If you are unwilling to be screened yearly until you no longer have risk factors for lung cancer
  • If you have already developed symptoms of advanced lung cancer
    • Weight loss without trying
    • New cough that will not go away or change in a chronic cough
    • Coughing up blood

7.  Initial visit and follow-up

  • On the day of your first appointment, we will confirm that you are eligible for screening. This may be done either by providing documentation from your physician or by a brief visit with a nurse practitioner or physician. If you are eligible, we will perform a low dose lung CT scan, which only takes a few minutes.

8.  What should I expect during a CT scan?

  • The CT scanner is a large, box-like machine with a hole, or short tunnel, in the center. During the test you will lie on your back on the table which moves through the center of the machine. When the machine is ready to start the scan, you may be asked to hold your breath briefly in order to create a clear picture of your lungs. The table will move slowly through the machine as the images are created. The machine may make knocking or clicking noises. You must not move during the study. The entire procedure, which includes set-up, the scan itself, and checking the pictures, takes around 30 minutes.
    • You must change into a hospital gown
    • No metal will be worn
    • The technologist will move to another room where he/she can see you and talk with you.

9.  Are there risks involved in CT screenings?

  • Low dose CT scans for patients that smoke (see above) can lead to a lower chance of dying from lung cancer. Low dose CT scans are also less expensive and safer than invasive procedures.
  • At the low doses of radiation a CT scan uses, your risk of developing cancer from it is so small that it can't be reliably measured. Because of the possibility of an increased risk, however, the American College of Radiology advises that no imaging exam be done unless there is a clear medical benefit.

10.  What happens if the scan shows something unusual?

  • A radiologist with expertise in interpreting radiology examinations will analyze the images and send an official report to your primary care physician or physician who referred you for the exam, who will discuss the results with you.
  • Follow-up examinations may be necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a potential abnormality needs further evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary so that any change in a known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see if treatment is working or if a finding is stable or changed over time.  Sometimes abnormalities found on the CT scan may require further work-up, such as biopsy or other procedures.