Cancer Risk Reduction

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Lung Cancer Screening

The American Cancer Society (ACS) recommends that physicians discuss CT screening with patients who are current or former smokers and meet certain criteria. This recommendation is based on a large study involving more than 50,000 people between the ages of 55 and 74 with a current or former history of heavy smoking, which was defined as 30 pack-years. (A pack-year is the equivalent of smoking 1 pack of cigarettes per day for a year. Someone who smokes 2 packs per day would accumulate 30-pack years within a 15-year period, etc.) Former smokers in this study had quit smoking within the past 15 years. The type of CT scans that were done in this study involve significantly less radiation exposure than chest CT scans in the past.  

Thus, the criteria that are used to determine who is eligible for screening reflect the criteria for this study: age 55-74, current or former smoker, at least 30 pack-years of cigarette use. In addition, the ACS recommends screening primarily for individuals who are otherwise in generally good health. Anyone who is having symptoms that might suggest the presence of lung cancer (such as persistent cough, unexplained weight loss, unexplained shortness of breath, etc.) should undergo medical evaluation that might include chest CT. However, in this situation, the CT scan is considered a diagnostic test rather than a screening test. “Screening” refers to testing that is done to detect disease at an early stage, before the onset of symptoms.

As of December 2013, the United States Preventive Services Task Force (USPSTF) has also officially endorsed annual screening with low-dose chest CT for current or former smokers. Eligibility guidelines are similar to those listed above, though the USPSTF includes those between 55 and 80 years old. Former smokers no longer meet guidelines if they quit more than 15 years ago, or are no longer capable of undergoing lung surgery (if indicated by CT results).

My Pledge

To reduce my risk of developing lung cancer, I will talk to a healthcare provider about whether I should get a chest CT scan to screen for early lung cancer, based on my personal smoking history.

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