You should already know that every time you light up a cigarette you’re doing your lungs harm. Statistics point out the grim reality: Smoking is to blame for about 90 percent of lung cancer cases, according to the American Cancer Society. While quitting can greatly reduce the risk, even after 15 smoke-free years, ex-smokers are twice as likely to develop the disease than those who never smoked (though this is no excuse not to quit). People who’ve been exposed to secondhand smoke and those who’ve been in contact with hazardous materials such as radon and asbestos are also vulnerable.
So, if you fall into any of these high-risk categories, should you be screened for lung cancer?
Currently, the American Cancer Society and the U.S. Preventive Services Task Force don’t recommend routine screening for lung cancer in people who have no symptoms of the disease. That’s because the available tests come with significant disadvantages. For example, chest X-rays and sputum (spit) tests—two standard procedures for detecting lung cancer—don’t usually pick up the disease early enough to improve a person’s chance of survival.
A computed axial tomography (CT) scan called spiral CT may help find early lung cancers, particularly in current and former smokers. But even this method may not help lower your risk of dying from the disease or help you live longer than you would have without screening.
The reason? Spiral CT scans are a little too good at detecting spots or nodules on the lungs, so about half of people undergoing testing will have one or more nodules appear on their scan. But the test can’t tell whether those growths are actually cancer. This not only causes anxiety, but leads to months of follow-up and further testing for many people who will ultimately test negative for lung cancer. In addition, some follow-up tests are risky because they’re invasive. For example, a biopsy needle may cause part of the lung to collapse.
The benefits of spotting lung cancer at an early stage are further complicated by the fact that some cancers are so slow growing that they’re unlikely to cause symptoms or death. Other cancers are so aggressive that treatment won’t prevent death. Still, an early diagnosis increases the chances that surgery—the best treatment for most types of lung cancer—can remove the cancer. Positron emission tomography (PET) imaging may offer the best hope. PET imaging can tell the difference between benign and malignant tumors as small as one centimeter, according to a new study reported in the Journal of the National Cancer Institute.
Speak with your doctor about whether your smoking history, exposure to toxins or general level of health would make you a good candidate for screening.