Low-dose CT scans for lung cancer: How they work and who needs one

Lung cancer is the second most common cancer among people in the United States. It is the country’s leading cause of cancer deaths, according to the American Cancer Society, which forecasts 226,650 new lung cancer diagnoses this year.

Cigarette smoking is the No. 1 risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancer deaths, according to the Centers for Disease Control and Prevention.

That’s why it is very important for our high-risk patients to receive a lung cancer screening before they show symptoms of the disease. Treatment is easier and more effective when lung cancer is caught in its early stages.

One of the best tools we have to identify lung cancer is low-dose computed tomography, or LDCT screening. It is a quick, painless and noninvasive diagnostic test.

Here are common questions patients have about the screening, which is available at locations in Calumet City, Crown Point, Flossmoor, Harvey, Hyde Park, Orland Park, River East and Tinley Park.

What is low-dose CT screening?

This screening, a type of CT imaging scan, is a great way to get a detailed look at the lungs so we can see if there are any nodules with features that might indicate a patient has cancer. (The scan also shows the heart, bones, and abdomen.)

If a nodule is worrisome, we might order a followup, biopsy or a direct referral to a thoracic surgeon for further evaluation. We can look for emphysema (areas of lung tissue loss) and other chronic changes in the lungs that may be helped with other treatments.

What is the difference between an LDCT and a regular CT scan?

LDCTs use about 20% of the radiation involved in a traditional CT scan. The technology was developed to minimize radiation exposure to patients, and they expose a patient to about the same amount of radiation they would receive from sunlight over a period of one year.

Who should get an LDCT scan for lung cancer?

According to current guidelines, anyone between the ages of 50 and 80 years old who has a 20 pack-year smoking history or greater should be screened. (One “pack-year” means someone smoked about one pack of cigarettes per day for an entire year.)

Even if someone has stopped smoking in the last 15 years, we still recommend they get screened.

How long does a low-dose CT scan take?

The screenings are fast; they take about a minute or less. Patients will likely spend more time checking in for their appointment than at the scan itself.

Are there any risks or side effects to LDCT screenings?

There are no physical side effects to LDCT screening.

Some patients may feel anxious with results.

Biopsies or other interventions that may come after a screening may pose other risks — but we know from studies that people who get screened and treated early are more likely to survive than those who don’t get screened at all.

Can you eat before an LDCT scan?

We recommend patients stop eating roughly four hours before a scan. Although eating shouldn’t cause any issues with the procedure itself, we advise taking a break beforehand to prevent someone from becoming nauseated if they are anxious about the procedure.

When should LDCT screening for lung cancer stop?

While current guidelines recommend people between the ages of 50 and 80 get screened, many people are living longer with a better quality of life, which means someone older than 80 could still get screened.

Patients aging out of this range are encouraged to discuss the benefits of extended screenings with their care team.

Will my insurance cover LDCT screening?

In most cases, low-dose CT scans are covered by insurance. It gets a little tricky with patients over 77 who are on Medicare, as the program has stopped covering screenings for patients 78 and older.

What else should people consider?

Although lung cancer can be caused by environmental or genetic factors, there’s one proven method to prevent the disease: stop smoking.

Lung cancer has a high death rate, especially if not detected early, with a death rate of 80% after 5 years. But if we can detect lung cancer in its earliest stage, we have about an 85% cure rate!

*James A. Wallace, MD, is a UChicago Medicine Medical Group provider. UChicago Medicine Medical Group comprises UCM Medical Group, Inc. f/k/a UCM Care Network Medical Group, Inc., and UCM Medical Group Sub, LLC f/k/a Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine Crown Point, UChicago Medicine River East, UChicago Medicine Orland Park, UChicago Medicine Ingalls Memorial, UChicago Medicine at Ingalls-Calumet City, UChicago Medicine at Ingalls-Flossmoor, or UChicago Medicine at Ingalls-Tinley Park.