What to know about USPSTF lung cancer screening

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In people with cancer, certain cells in their bodies grow uncontrollably. Lung cancer is a disease where this uncontrollable cell growth begins in the lungs.

There are two main types of lung cancer: small cell and nonsmall cell. The latter makes up about 85% of lung cancer cases.

Symptoms

The symptoms of lung cancer can be different for each individual. But some of the more commonly reported symptoms include:

• shortness of breath
• feeling tired or lethargic
• unexplained weight loss
• pain in the chest
• a lingering cough that may worsen over time
• wheezing
• coughing up blood

People with lung cancer may also have issues with ongoing pneumonia, which refers to an inflammation of one or both lungs.

Causes

Smoking cigarettes causes roughly 90% of lung cancer cases. Tobacco smoke has different chemicals that can cause this form of cancer. People with exposure to secondhand smoke are also at a higher risk of developing lung cancer.

Exposure to radon gas can also cause lung cancer. This gas occurs naturally in water, rocks, or soil. If radon accumulates inside a house or building, it can contaminate the air indoors.

Other substances may likewise increase the risk of lung cancer. These can include:

• arsenic
• diesel exhaust
• asbestos

Finally, people with a family history of this cancer are at a higher risk of developing the disease themselves.

The USPSTF updated its lung cancer screening guidelines in 2021. These guidelines recommend annual lung cancer screening for people at high risk. These include individuals who:

• are between 50 and 80 years old
• have a 20-pack year smoking history
• smoke currently or quit smoking within the last 15 years

A pack year refers to a year in which someone smokes one pack of cigarettes every day. Smoking daily for extended periods increases the risk of lung cancer considerably.

The USPSTF recommends screening people who meet these criteria every year until they have not smoked for 15 years. They also advise discontinuing screening if an individual develops a health condition that significantly reduces their life expectancy or would prohibit lung surgery.

Previous USPSTF guidelines recommend people undergo screening at the age of 55 years. The new guidelines lowered the screening age to increase the chance of detecting and successfully treating lung cancer in younger individuals.

They also reduced the number of pack years, from 30 to 20. These expanded guidelines cover more individuals at risk of lung cancer. This may ultimately help reduce the number of lives lost to this disease.

The USPSTF advises medical professionals to carry out lung cancer screening with low dose CT (LDCT) scans. An LDCT device takes images of the internal body parts with an X-ray machine and sends these images to a computer.

Taking pictures at different angles allows the computer to create 3D images. These images can show unusual changes to tissues or organs.

Catching lung cancer early dramatically improves the chances of responding to treatment. With LDCT screening, doctors can recognize the early signs of lung cancer before it has spread.

Research shows that LDCT screening reduces mortality from lung cancer. However, in some cases, LDCT can lead to false positive or inconclusive results.

This is why LDCT screening is recommended only for those already at high risk of developing lung cancer. For these individuals, LDCT may help catch lung cancer early and lead to successful treatment.

People with lung cancer have various treatment options. Finding the right option depends on the individual and the disease stage. Some treatments for lung cancer include:

• undergoing surgery
• receiving radiation therapy or chemotherapy
• participating in a clinical trial
• immunotherapy
• targeted therapy

The treatment also depends on the type of lung cancer. In the early stages, surgery alone may be enough to cure nonsmall cell lung cancer.

In the later stages, chemotherapy, radiation therapy, or immunotherapy can help. When cancer has spread throughout the body, a doctor may recommend clinical trial participation or palliative care.

The journey through lung cancer is highly personal. Treatment plans may include conventional medical options, investigative trials, and complementary therapies. Individuals living with lung cancer should speak with a doctor to develop a treatment plan that works best for them.

Below are some of the most common questions and answers about lung cancer.

Should people who smoke have lung cancer screening?

According to the USPSTF, people who have smoked at least 20 pack years should receive lung cancer screening.

An individual who smoked one pack every day for 20 years would be eligible for screening. Alternatively, someone who smoked two packs daily for a decade would also be eligible.

Can a blood test detect lung cancer?

Blood tests are not currently able to detect lung cancer. However, a doctor may need to conduct blood tests after diagnosis. They may run blood chemistry tests to take a look at a person’s organ function. This can help them determine whether the cancer is affecting other parts of the body, which could mean that it has spread.

They may also order a complete blood count test. This test can detect abnormalities in different blood cell types. This could warn the doctor of potential issues with bleeding or infections during lung cancer treatment.

Is lung cancer treatable if doctors find it early?

The LDCT screening test can help detect lung cancer before an individual experiences symptoms. Finding lung cancer in the early stages increases the likelihood of recovering from this disease.

Research indicates that people who receive an early diagnosis have around a 56% likelihood of survival 5 years following their diagnosis. However, the overall 5-year survival rate for lung cancer is 18.6%.

Although lung cancer is the leading cause of death from cancer, early detection increases the chance of making a full recovery.

Older individuals with a long history of smoking are at a particularly high risk of developing lung cancer. The USPSTF lung cancer screening guidelines recommend an annual screening for these people.

This screening may detect lung cancer before it causes symptoms. Starting treatment in the early stages of this disease increases the chance of recovery.