Tips to Live By

Why You Shouldn't Brush Off Lung Cancer Screening

Oct. 18, 2024 - Katie McCallum

We tend to think we'll know when something is wrong with our health — that our body will alert us. But if you're at high risk of developing lung cancer and relying on just symptoms to tell you when something might be wrong, you're waiting too long.

"By the time lung cancer symptoms appear, the cancer has typically already progressed and become harder to treat," warns Dr. Priya Oolut, a pulmonologist specializing in lung nodules at Houston Methodist.

Smoking remains the No. 1 risk factor, linked to an estimated 80% of cases.

The 5-year survivability of stage 1 lung cancer is about 85%. This rate drops to just 20% if lung cancer isn't caught until stage 4. The good news, though, is that lung cancer can be detected in its earliest stages via screening. Unfortunately, the majority of people who are eligible aren't getting screened, Dr. Oolut notes.

"About 70% to 80% of people who should be getting lung cancer screenings aren't, and there are a few reasons for this," says Dr. Oolut. "One of the biggest barriers to screening is the stigma around smoking. People aren't comfortable admitting their smoking habits to their healthcare providers. But it's critical to be open with your physician about this."

It's also a newer type of cancer screening, and many people who are eligible may not even be aware the screening exists. Dr. Oolut is here to explain everything we need to know about the screening, from why it's important to what to expect.

"The really critical message is that catching lung cancer early saves lives," adds Dr. Oolut. "And early detection not only helps improve overall prognosis and outcomes, but it also influences a person's treatment plan — reducing time spent in the hospital, for instance."

There are no early warning signs of lung cancer

According to the American Cancer Society, lung cancer is the world's most commonly diagnosed cancer and leading cause of cancer death. With a disease so prevalent and deadly, it's critical to take a proactive approach, especially if you have a current or previous history or heavy smoking.

"Lung tissue lacks pain receptors," Dr. Oolut explains. "This means cancer isn't sensed as pain and often goes unnoticed until it spreads to other areas of the body."

Foremost among those areas are the airways, where it can lead to a persistent cough as it irritates cough receptors.

"At this point, the cancer has already grown, spread and become harder to treat," warns Dr. Oolut. "As often as we can, we want to use the tools available to us to catch lung cancer before it becomes something untreatable."

What is lung cancer screening, and who needs it?

Just as mammography and colonoscopy can be used to catch breast cancers and colorectal cancers before symptoms arise, the same is true for lung cancer screening.

"It's a preventive measure meant for high-risk individuals who are asymptomatic but who we know are significantly more likely to develop lung cancer over the course of their lives," explains Dr. Oolut.

Because smoking is the No. 1 risk factor for lung cancer, heavy smokers have the highest risk.

"Long-term studies have helped define this risk, and we use what's called 'pack years' — which gives an estimate of how much nicotine a person has been exposed to over time," says Dr. Oolut. "High risk is defined as having at least a 20-pack year smoking history."

A 20-pack year smoking history can look like:

  • 2 packs per day for 10 years
  • 1 pack per day for 20 years
  • 1/2 pack per day for 40 years


"This may not seem like a lot to some people, but the data are very clear that, over time, this amount of nicotine exposure is enough to cause cancer," says Dr. Oolut. "So we want to make sure we capture these people and make sure they're proactively being screened."

How does lung cancer screening work?

If your doctor recommends a lung cancer screening, don't brush it off. It's a small effort that could make a huge difference to your health.

During a lung cancer screening, low-dose CT (computed tomography) is used to take detailed images of your lungs. The imaging is quick and painless, and the scan itself takes just five to ten minutes. There's no need for contrast dye and IVs, meaning it's a completely noninvasive test. You simply lie on a table that moves through the CT scanner, which captures cross-sectional images of your lungs to detect any abnormalities — such as nodules — that could indicate early-stage cancer. The screening is covered by insurance for those who meet eligibility criteria and repeated each year to ensure consistent monitoring.

"It's a simple yet powerful test that can potentially save your life," says Dr. Oolut.

Talk to your doctor if you're unsure about your lung cancer risk

If you are a smoker or former smoker, talk to your primary care doctor about whether you qualify for screening. Your doctor can review your smoking history with you and order the test if you meet the criteria.

"Smoking stigma should never stop anyone from getting screened because early detection can truly be lifesaving," says Dr. Oolut. "It's so important to have an open, honest conversation with your doctor so that they can fully understand your lung cancer risk and offer you the best care. Your health should always come first."

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Categories: Tips to Live By