Lung cancer screening uses low-dose computed tomography (LDCT) i.e. a CT scan with a low dose of radiation, to find lung nodules, some of which may be cancer. People who take part in screening can lower their chances of dying from lung cancer.
Screening means testing for a disease when there are no symptoms or history of that disease. Doctors recommend a screening test to find a disease early, when treatment may work better.
In general, lung cancer screening is not a single test but a process that must be done correctly under the direction of your doctor(s).
Lung cancer screening is not appropriate for everybody. According to the Centers for Medicare & Medicare Services (CMS), below is the eligibility criteria for Medicare insurance coverage for the exam:
- Age 55–77 years
- Asymptomatic (no signs or symptoms of lung cancer)
- Tobacco smoking history of at least 30 pack-years (one pack-year = smoking one pack per day for one year; 1 pack = 20 cigarettes)
- Current smoker or one who has quit smoking within the last 15 years
- A written order for lung cancer screening with LDCT
A pack-year is used to describe how many cigarettes you have smoked in your lifetime, with a pack equal to 20 cigarettes. If you have smoked a pack a day for the last 30 years, or two packs a day for the last 15 years, you have 30 pack-years. Click here to calculate how many pack years you have.
Review information for the CT lung cancer screening initiative from the American Lung Association
High-risk individuals insured by Medicare will have screening covered up through the age 77.
Other health insurance plans that cover CT lung cancer screening include:
- Peoples Health Network
- United Healthcare
For those with private insurance coverage, your qualified health professional will need to obtain the proper insurance authorization for this screening.
For those with no insurance coverage, or in cases where private insurance has denied coverage, the fee for the exam is $200.
For a low-dose CT screening, you will lie flat on the exam table. Pillows and straps may be used for comfort, to help you maintain the correct position and to help you remain still during the exam. You will usually be asked to hold your arms over your head. Next, the table will move through the scanner to the correct starting position for the scans. Then, while you hold your breath for 5 to 10 seconds, the table will move through the machine as the actual CT scan is done. The entire appointment is about 10 minutes in length.
What happens after your first screening?
If a lung nodule is found on your CT scan, your doctor may recommend a follow-up CT scan, usually 6 months later to check that the nodule has not grown. In the unlikely case that the nodule does grow or may present a worry, your doctor may recommend further testing using a PET/CT scan or a biopsy (taking out a small piece of the nodule).
However, since it has been reported that the vast majority of lung nodules found are not cancer, you may only need to go back in one year as with other annual health checks to continue the process of screening. Remember, lung cancer screening is not a single test: it is a process that must be done correctly under the direction of your doctor(s).
How much radiation exposure will be incurred?
CT scanning for lung cancer screening uses up to 90% less radiation than a conventional chest CT scan. The approximate effective radiation dose is 1.5 millisievert (mSv), which is equal to about 6 months of “normal” background radiation and has very low risk. In fact, no correlation has been found between background radiation and cancer risk. The additional risk of developing fatal lung cancer from one adult exam is low enough that it is difficult to measure, with the estimated chances being between 1 in 100,000 and 1 in 10,000.
CT lung cancer screening requires a imaging exam referral order, also known as a prescription, from your physician or health care provider.