By DR. GRAHAM A. COLDITZ
Siteman Cancer Center
Even with COVID-19 still dominating health news, stories about new lung cancer screening guidelines were able to break into recent headlines, and for good reason.
Lung cancer is the second most common cancer in the U.S. — and the deadliest, killing more than 130,000 people each year. More people are now eligible for lung cancer screening because of updated guidelines from the U.S. Preventive Services Task Force, which can translate into additional lives saved.
Most lung cancers are currently diagnosed at advanced stages, where treatment is difficult and the chances of surviving five or more years is very low –just around six percent.
BENEFITS OF SCREENING
Annual screening for people at high risk can help find the disease earlier, when it can be more effectively treated. If found in the earliest stage, the chances of surviving five or more years increases to about 60 percent.
Screening is done with a scan called low-dose computed tomography, or low-dose CT. And in current and former smokers with a significant smoking history, it lowers the risk of dying of lung cancer by up to 25 percent. Findings from lung cancer screening can also help manage some heart conditions.
The new guidelines recommend yearly screening for people ages 50 to 80 who currently smoke or quit in the past 15 years, and have smoked the equivalent of one pack a day for 20 years. This opens up screening to many more people by lowering the age to start scans and lowering the level of smoking needed to qualify.
It’s estimated that six million more Americans will qualify for screening now. And, importantly, it is expected to help address inequalities in the original guidelines with greater increases in screening eligibility for women, African Americans, Hispanics and American Indians and Alaska Natives.
ANXIETY AND STRESS
Despite the proven benefits, lung cancer screening does have some potential harms, which is why it’s limited to people at increased risk because of their smoking history. Potential harms can include short-term stress and anxiety about unclear scan results, the need for follow-up testing for suspicious findings that turn out not to be cancer, and exposure to low amounts of radiation from a scan – about a third of the amount people are normally exposed to in a year. Overall, the benefits of lung cancer screening are thought to outweigh the harms, though it is a personal balance for each person.
WHAT TO DO
If you’re a current or former smoker 50 to 80 years old, talk to a health-care professional to see if you’re eligible for screening and if it’s right for you. If you choose to get screened, try to have it done at a facility with experience doing lung cancer screening with low-dose CT.
Keeping up with lung screening every year is also key. The benefits come after repeated scans. So if you missed a scan last year because of the pandemic, or just skipped a year or two, call your provider and get back on track.
TRY TO QUIT
And, of course, if you smoke it’s important to try to quit, even if you get screened. Screening doesn’t take away the dangers of smoking. Quitting smoking, though, can build on the benefits of screening by lowering the risk of lung cancer as well as other deadly diseases, like heart disease, stroke, COPD and many other cancers. For tips and resources on quitting, call 1-800-QUIT-NOW (1-800-784-8669), or visit smokefree.gov.
This last year has made us appreciate even more than usual the importance of looking after our health, and looking after each other. And lung cancer screening can be a key part of that for many people.
If you have a friend or family member who may be eligible for screening, encourage them to talk to a provider about it. And if you think you may be eligible, be sure to do the same.
It’s your health. Take control.
(Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.)