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Lung cancer screenings: Early detection for a deadly disease

Pulmonologist and Critical Care Physician Abbie Begnaud, MD, answers some common questions about lung cancer screenings.
Lung cancer screenings can help identify cancer in an early stage before it has spread to other systems. Still, University of Minnesota Health Pulmonologist and Critical Care Physician Abbie Begnaud, MD, says only high risk patients should consider lung cancer screenings.

Should I get screened for lung cancer? When should I start screenings? Are there any risks?

Lung cancer screenings can provide early detection for a deadly form of cancer, but many don’t know the test—using low-dose computed tomography—is an option.

We asked University of Minnesota Health Pulmonologist and Critical Care Physician Abbie Begnaud, MD, for answers to some common lung cancer screening questions. Begnaud explains who should receive a screening and what patients should expect during their screening, which is a service provided at University of Minnesota Medical Center and University of Minnesota Health Maple Grove Clinics.

Why are lung cancer screenings important?
Lung cancer is the leading cause of death from cancer in the United States. Unfortunately, early lung cancer typically has no early symptoms. By the time a person with lung cancer has symptoms, the cancer is likely to have spread or metastasized. Because most people are diagnosed when the cancer is already at an advanced stage, it is life-threatening and difficult to treat.

While lung cancer screenings can’t prevent you from getting cancer, they can help detect cancer in its earliest stages, when they are treatable and potentially curable. Annual screening can help lower the risk of death from lung cancer by nearly 20 percent.

Who should receive them?
Lung cancer screening is recommended for current and former smokers based on age and smoking history. The national guidelines for who should be screened include:

  • Men and women between the ages of 55 and 79 (ages 55-77 for Medicare patients)
  • Have smoked at least a pack of cigarettes a day for 30 or more years
  • Currently a smoker or have quit within the past 15 years

If you meet these criteria, you are a good candidate for annual lung cancer screening. However, if you have a new cough or shortness of breath, you should talk to your doctor before being screened.

“Only high-risk patients should be screened. Screening can be life-saving but also has potential downsides that do more harm than good if a person has a low risk of lung cancer. Although other factors contribute to lung cancer risk, eligibility for screening is based mainly on a person’s smoking history,” Begnaud said.

Learn more about the University of Minnesota Health lung cancer screening program.

When should screenings begin?
All high-risk smokers who are eligible should get screened when they turn 55. Eligible patients older than 55 who have not yet received a screening should consider the procedure as well.

What risks are associated with screening?
For high risk patients, the benefits of a screening greatly outweigh the risks. However, there are still some points a person should consider before screening.

Patients must limit how often they’re screened, because there is a risk of radiation exposure, Begnaud said. Lung cancer screenings also have a relatively high false-positive rate. Roughly 25 percent of patients receive a positive result, but the cause of the false positive may actually be an old infection, scar in their lung or other source. These patients may receive a letter notifying them about the possibility of cancer, but they should consult with their doctor before drawing conclusions.

“If you get a positive result it doesn’t necessarily mean that there is a problem, it just means we may need to do further testing,” Begnaud said.

Do I need to do anything for I go in for my screening?
No preparation is needed prior to a lung cancer screening.

What should I expect at my screening?
When patients check in for their screening, they will likely be asked to complete a short questionnaire about their smoking history and any other risk factors, including their family history. The screening itself is a very speedy process, and takes less than a minute to complete. It is also a painless process, Begnaud said.

What makes our lung cancer screening program different?
Our program is recognized by the Lung Cancer Alliance as a Screening Center of Excellence, the only one in Minnesota. This means that we adhere to the highest standards for screening and treatment protocols by working as a multi-disciplinary clinical team to deliver coordinated, comprehensive care for screening, diagnosis and treatment. What that means to the person being screened is that they will receive personalized care by a team of experts with experience in lung screening, and diagnostic tests or treatments, if needed.

"Having a multidisciplinary team in place ensures that we can take a personalized approach to the diagnosis and treatment of any abnormalities we find on a screening exam,” Begnaud said.