Lung cancer remains the leading cause of cancer death in the United States, but early detection and treatment can save lives.
For those who are eligible, UPMC offers low-dose CT scans to screen for pulmonary nodules — dense growths made up of tissues or cells that, in certain cases, can increase a person’s risk of developing lung cancer.
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Screening for Lung Nodules
“A lung nodule itself isn’t necessarily cancerous or dangerous, but if it undergoes certain changes over time, it can develop into lung cancer,” says Reinaldo Garcia, MD, who specializes in critical care medicine and pulmonology at UPMC. “Most nodules are found by accident, or incidentally, when someone is getting a scan for something else. They may come into the emergency room complaining of abdominal pain, for example, and a scan of the abdomen catches a lung nodule.”
Lung nodules are fairly common, Dr. Garcia says, and may form following a lung injury or infection. The vast majority of lung nodules are non-cancerous, he adds, but consulting with a physician or pulmonary specialist can ensure a nodule isn’t something more serious.
Certain groups are more likely to develop lung cancer, including longtime cigarette smokers, people with chronic obstructive pulmonary disease (COPD), people with a strong family history of lung cancer, and people who have had exposure to radon, asbestos, diesel fumes, or heavy secondhand smoke.
Lung Cancer Risk Factors
People with at least a 20-pack-year history of smoking (one pack per day for 20 years, two packs per day for 10 years) are at the greatest risk.
“Cigarette smoking ends up being responsible for about 90% of lung cancer cases,” Dr. Garcia says. “If someone is found to have a nodule, but they don’t have a history of smoking, we usually follow it with serial exams depending on what the nodules look like over the course of six months to a year. A nodule that’s been there for several years and hasn’t grown or changed at all — and the lung is otherwise healthy — is unlikely to become cancerous, but a nodule that’s grown over the course of one to two years, let’s say, has a higher chance of developing into cancer.”
After smoking, radon exposure is the second-leading cause of lung cancer in the U.S. Pennsylvania has one of the most serious radon problems in America, with about 40% of Pennsylvania homes testing above the U.S. Environmental Protection Agency’s action guidelines for radon. This odorless, colorless, and radioactive gas often enters homes from the ground through cracks in the foundation. Testing your home for radon using a home radon test is important for your safety.
Because lung cancer often has no symptoms in its early stages, screenings are key to ensuring the best possible outcome. One study published in The New England Journal of Medicine with UPMC’s participation found that screening high-risk individuals for lung cancer with low-dose CT scans leads to 20% fewer deaths due to earlier detection.
“Screening for lung cancer has the same purpose as screening for any other type of (cancer),” says Dr. Garcia. “The earlier we detect something, the more easily treatable it is. A Stage 1 cancer is more easily treated than a stage 4 cancer.”
To be eligible for a low-dose CT scan screening, patients must have a written prescription from a primary care provider or another health care professional.
For the most part, eligible candidates are:
- People between 50 and 79 years of age.
- People with at least a 20-pack-year history of smoking.
- (one pack per day for 20 years, two packs per day for 10 years, etc.)
- Current smokers or those who have quit within the past 15 years.
- People who are not in treatment for cancer.
For patients who don’t meet the criteria, a primary care provider may determine one is necessary and write a prescription.
The screening process itself is simple. Patients change into a gown and lie on the CT scanner table. The scanner makes a few rotations around the chest, and the test is complete. The specialist will later share the results with the patient and referring physician.
“For the screening, the vast majority of the time it tends to be ordered by a primary doctor,” Dr. Garcia says. “But we also see patients in our pulmonary offices that we refer because they’re coming to us for a different concern and we see that they meet criteria.”
In some cases, there are certain drawbacks to these screenings, Dr. Garcia says, but for eligible candidates, the benefits of early lung cancer detection outweigh the risks.
“If we do end up screening someone, we sometimes find things incidentally,” he says. “The majority of these incidental findings don’t end up being anything life-threatening or dangerous but can lead to having more ancillary testing done to confirm those findings.
For more information on UPMC’s Lung Cancer Screening Program and low-dose CT scan screenings, visit the UPMC website. Here’s a shared decision-making tool that offers facts about lung cancer screenings and the options, benefits, and risks of participating in the program.
When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.