MD Anderson Cancer Center
Date: June 2012
Hello I'm Don Armstrong. This video is for men and women aged 50 years and older with a smoking history equivalent to 1 pack of cigarettes a day for 20 years. These men and women may benefit from lung cancer screening. If you are not 50 years or older or do not have a smoking history equivalent to 1 pack of cigarettes a day for 20 years, we do not know if the benefits of lung cancer screening will outweigh the potential harms.
Currently the best screening test for lung cancer is a low-dose spiral computerized tomography or CT scan. It is used to find tumors or other abnormalities. This video will give you the information you need to talk with your healthcare provider and make a decision about lung cancer screening with a spiral CT scan.
The lungs are sponge-like organs located in the chest as part of the respiratory system. Lung cancer is a disease in which lung cells grow out of control and form a mass or tumor.
Lung cancer is the leading cause of cancer death among both men and women. More people die from lung cancer each year than from colon, breast, and prostate cancers combined. Smoking is by far the most important risk factor for developing and dying from lung cancer. Smoking is responsible for 90 percent of all lung cancer cases and 87 percent of all lung cancer deaths in the United States.
If you are still smoking, please ask your healthcare provider for information about MD Anderson's Tobacco Treatment Program.
Cancer screening is used to find a cancer before a person has any symptoms. This can help find cancers at an early stage when they're easier to treat.
The National Lung Screening Trial, a large research study, recently identified low-dose spiral CT scans as being able to find lung cancer early and lower the chance of dying from lung cancer.
A low-dose spiral CT scan is a simple, pain-free procedure which uses x-rays to scan the entire chest in 12 to 20 seconds. Throughout the procedure the patient lies very still on a table while passing through the x-ray machine. The machine rotates around the patient and a computer creates 3D images from the scan.
Findings from the CD scan will determine your next steps. If something suspicious is found on the scan, your healthcare provider may ask you to return to the clinic for additional tests and procedures such a biopsy. If nothing is found on your CT scan, you should repeat the scan in 1 year. Your healthcare provider will be able to answer questions concerning follow-up.
Results from the National Lung Screening Trial showed that screening with a low-dose spiral CT lowered a person's chance of dying from the lung cancer by 20 percent, compared to screening with a chest x-ray.
You can see these results by looking at 10 people who died from lung cancer; 2 of these people would not have died if all 10 had been screened with low-dose CT instead of chest x-ray.
There are also some potential harms of screening for lung cancer with a spiral CT.
Patients are exposed to a low-dose of radiation. The radiation received during one low-dose spiral CT is much less than the radiation dose from a standard chest CT, but a little more than the dose received from a mammogram. The overall risk from spiral CT scanning of the lungs over many years is not known.
The CT scan may provide false results. It may miss a tumor which may leave a person with false reassurance, or it may indicate that you have cancer when you do not which may result in unnecessary tests and procedures.
Out of 100 participants who were screened with a low-dose spiral CT, 24 had a result which was suspicious for lung cancer; the other 76 did not and we do not know if this is because the CT missed a tumor. If we look closer at only the 24 individuals with a result which was suspicious for lung cancer, we can ask, "How many of these were diagnosed with lung cancer?" Out of these 24, only 1 was diagnosed; the other 23 who were not diagnosed may have had additional tests and procedures such as more imaging or a biopsy before it was known that they did not have lung cancer. There are some other things to consider when deciding whether screening for lung cancer is right for you.
Although rare, screening may find small cancerous tumors that would never grow to be life-threatening. This may cause a patient to experience anxiety and have unnecessary tests or procedures.
Since the CT scan takes pictures of a patient's entire chest, there is potential to find other abnormalities that are not in the lungs, such as heart disease.
If cancer is found, treatment may include surgery, chemotherapy, or radiation.
When looking at the potential benefits and harms of lung cancer screening with a low-dose spiral CT scan, think about the reasons you would choose to be screened and reasons you would choose not to be screened. Keep in mind that your reasons are personal and may differ from your friends, family or coworkers. You should weigh the potential benefits against the potential harms and talk with your healthcare provider before making your final decision.
© 2012 The University of Texas MD Anderson Cancer Center
1515 Holcombe Blvd, Houston, TX 77030
1-800-392-1611 (USA) / 1-713-792-2121