“Why should I get screened for lung cancer?” Many women ask this question, because they falsely believe that lung cancer is a “man’s” disease.
Consider these facts:
In the United States, more women die from lung cancer than any other cancer.
Lung cancer causes more deaths than breast, ovarian, and cervical cancers combined.
In 1987, lung cancer passed breast cancer to be the #1 cause of female cancer death.
About 25% of all American cancer deaths are caused by lung cancer.
Worldwide, over 50% of women with lung cancer are nonsmokers.
In 2021, the National Cancer Institute estimates that 235,760 Americans will be diagnosed with lung cancer; 116,660 will be women, almost as many as the 119,100 men who will be told they have lung cancer.(5) Lung cancer is the leading cause of death from all cancers.
How screenings can save your life
Testing for cancer before you feel ill or have symptoms is called screening. When you follow screening guidelines, cancers can be found early, when they are easier to treat.
HeartLung™ offers a low-dose CT scan that is all you need to check your lungs for nodules, which are solid areas that are embedded in the soft, sponge-like tissue of the lungs. This chest CT scan combines X-ray and computer technology to take detailed pictures of the lungs, as well as other organs, bones, and structures inside your chest and upper abdomen.
You may already have had some of the recommended screenings for women. Pap smears detect cervical cancer; today the U.S. death rate for cervical cancer has dropped by more than 50% over the past 30 years.(6) Thanks to mammograms, breast cancer mortality has been reduced by 40%.(7) A bone mineral density (BMD) scan can determine if you have developed osteoporosis, a serious bone disease that increases your risk of breaking a hip or other bone. (8)
Early detection of lung cancer was not successful
Lung cancer has been extremely difficult to diagnose in its early stage, before it spreads to other parts of the body. In the past, health care providers had to rely on chest X-rays and examination of sputum under a microscope to try and detect anything abnormal.(10)
The American Cancer Society reports that using chest X-rays as a screening method for people who are at risk for developing lung cancer doesn’t really save lives or help most people live longer.(11) Chest X-rays can’t detect small lesions or nodules that indicate the presence of early cancer. Factors like the location of the nodules or lesions, the quality of the X-ray, and the skill of the radiologist can all prevent an accurate reading.(9) By the time it shows up on a chest X-ray, a tumor is often the size of a dime, too late for a cure.(22) However, a HeartLung™ CT scan can find a nodule the size of a grain of rice, with a 92% chance of living for five or more years with treatment.(23,24)
Lung cancer tumors double in size every 3 to 6 months.(12) It could take several years for the most common type of lung cancer, non-small cell lung cancer (NSCLC) to be seen on a chest X-ray. For 70% of cases, the cancer is in advanced stages by the time symptoms appear: a nagging cough, chest pain, wheezing, and unwanted weight loss.(13)
An important medical study found a better way
Researchers wanted to find a method to evaluate people who were at risk for developing lung cancer due to cigarette smoking. In 2002, the National Cancer Institute sponsored a large, randomized clinical trial called the National Lung Screening Trial (NLST).
The purpose of the NLST was to determine whether screening low-dose chest CT scans could reduce death rates from lung cancer among those at high risk for the disease. The trial studied more than 53,000 men and women aged 55 to 74 who were current or former heavy smokers at 33 locations across the United States. The smokers had no signs, symptoms, or history of lung cancer. Each participant was randomly assigned to receive screenings with either low-dose CT or a standard chest x-ray once a year for three consecutive years.
In 2010, the first-ever solid results showed that there 15% to 20% fewer lung cancer deaths among participants screened with the low-dose CT,15 such as a HeartLung™ scan. It detected almost six times as many early lung cancers as chest X-rays, and most of these tumors were no larger than 1 cm in diameter, about ½ inch.(15) These cancers could be easily treated because they were found early.
Guidelines for lung screening
After the NLST results were released, new guidelines were announced to help diagnose lung cancer in people who are at high risk. According to the U.S. Preventive Services Task Force, recommendations are:
Adults 50- to 80-years-old who have a 20 pack-year smoking history and currently smoke or who have quit within the past 15 years
Screening should be done every year with a low-dose CT scan.
Discontinue the annual screening when the person has not smoked for 15 years, develops a serious life-limiting health issue, or is willing to have curative lung surgery.(16)
About 8 million Americans are considered to be high risk for lung cancer. If only 4 million would be screened every year, more than 12,000 deaths could be prevented.(3)
To calculate smoking history into “pack years,” simply multiply the number of cigarette packs smoked per day by the number of years smoking cigarettes. For example: 1 pack a day smoked over a 20-year period = 20 pack years.
Lung screening is for nonsmokers, too
The Auto-10™ scan by HeartLung™ will include your lungs. Lung cancer caused by smoking accounts for about 85% to 90% of all cases. Of the remaining cases, other factors will result in 20,000 to 40,000 cases a year among nonsmokers.17,25 Over 50% of those who develop nonsmoking lung cancer are women who never smoked or have smoked fewer than 100 cigarettes during their lives.(4)
Causes of lung cancer not related to smoking include:
Radon: Radon is a radioactive gas that occurs naturally and is found in the atmosphere in trace amounts. It is colorless, odorless, and tasteless. Outdoors, it scatters quickly and isn’t a danger. Indoors, it can become concentrated; breathing radon causes 21,000 lung cancer deaths a year.(18)
Secondhand smoke: Although laws have banned smoking in public places, about 7,000 people each year still die from breathing secondhand smoke.18
Workplace dangers: People who are exposed to carcinogens (cancer-causing substances) at work can develop lung cancer. Some carcinogens are asbestos, diesel exhaust, uranium, and arsenic.(18)
Air pollution: People who live in places with high traffic, dust, smoke, and chemicals have a slightly higher risk of lung cancer.(19)
Because nonsmokers were not included in the NSCLC trial, there is not enough evidence to recommend routine screenings. However, several studies have shown that the rate of lung cancer in nonsmokers is increasing.(4)
Paying for a lung screening
It is important to check with your insurance carrier before your low-dose CT scan. Even if the cost of the test is covered, ask about possible other out-of-pocket expenses.
Many private insurance companies pay for lung screening for high-risk individuals as part of preventive screening, usually with no co-pay. You may need to get a referral or preauthorization from your health care provider.
Medicare Part B (Medical Insurance) covers lung screening for high-risk individuals as part of preventive screening., at no cost. To qualify, you must meet all of these requirements:(21)
You’re age 55-77.
You don’t have signs or symptoms of lung cancer (asymptomatic).
You’re either a current smoker or have quit smoking within the last 15 years.
You have a tobacco smoking history of at least 30 “pack years” (an average of one pack of 20 cigarettes per day for 30 years).
You get a written order from your doctor.
For more information about Medicare coverage, visit www.medicare.govexternal icon or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1 (877) 486-2048.
What else is checked with a HeartLung™ screening scan?
When you choose a low-dose CT scan from HeartLung™ you will get much more than the results of your lung scan. Our goal is to prevent disease or identify it in early stages.
We offer an exclusive Auto-10™ scan that will provide ten detailed reports on areas of your body that cannot be evaluated by the usual physical examination or blood tests. At the same time as your lung scan—and with the same safe procedure—we can do an “internal check” and provide the following detailed reports:
Coronary Artery Calcium
Cardiac & Great Vessel Sizes
Lung Cancer Nodule Detection
Emphysema Score & Airway Measurement
Thoracic Fat & Muscle Measurements
Breast Density Measurement
Fatty Liver Disease Detection
Enlarged Lymph Nodes, Thymus & Thyroid
Hiatal Hernia & Esophageal Masses
Bone Mineral Density Measurement
Your HeartLung™ Auto-10™ scans are analyzed using Artificial Intelligence (AI), comparing them to thousands of other CT scans. Then a radiology physician will review them as part of our quality process. The detailed reports you receive are accurate and unbiased.
One more benefit of your HeartLung™ scan is that the smallest possible dose of radiation is used to obtain all Auto-10TM results. The procedure uses less than 1.5 mSv of radiation, about the same as six months of the background radiation you’re normally exposed to. By avoiding having separate CT scans, your radiation exposure in minimized.
REFERENCES
Lung disease. Office on Women’s Health, U.S. Department of Health & Human Services, Washington, DC. https://www.womenshealth.gov/a-z-topics/lung-disease (Accessed 7 September 2021)
The Facts About Women and Lung Cancer. Lung Cancer Research Foundation, New York, NY. https://www.lungcancerresearchfoundation.org/for-patients/women-and-lc/ (Accessed 7 September 2021)
Lung Cancer Fact Sheet. American Lung Association, Chicago, IL. https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet (Accessed 7 September 2021)
Dubin S, Griffin D. Lung Cancer in Non-Smokers. MO Med.2020 Jul-Aug: 117(4):375-379. (Accessed on PubMed 6 September 2021)
Lung and Bronchus Statistics. National Cancer Institute, Bethesda, MD. https://seer.cancer.gov/statfacts/html/lungb.html (Accessed 7 September 2021)
Cancer Screening Saves Lives. Publication 5728. Cancer Services Program, New York Department of Public Health, Albany NY. (https://www.health.ny.gov/publications/5728.pdf (Accessed online 7 September 2021)
Mammography Saves Lives. American College of Radiology, Reston, VA. https://www.acraccreditation.org/mammography-saves-lives (Accessed 6 September 2021)
USPSTF Recommendation Statement: Screening for Osteoporosis to Prevent Fractures. U.S. Preventative Service Task Force. JAMA. 2018;319(24): 25212531. https://jamanetwork.com/journals/jama/fullarticle/2685995 (Accessed 2 September 2021)
Wender R et al. American Cancer Society Lung Cancer Screening Guidelines. CA CANCER J CLIN 2013;63:106–117 (Accessed at https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21172 6 September 2021)
Lung Cancer Screening. RadiologyInfo.org. Sponsored by the American College of Radiology and the Radiological Society of North America. https://www.radiologyinfo.org/en/info/screening-lung#106dc97429164811ba9e6d7afa886f26 (Accessed on 7 September 2021)
Can Lung Cancer Be Found Early? American Cancer Society, Atlanta, GA. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/detection.html (Accessed 6 September 2021)
Handy, Jr J. Ask an Expert: Lung cancer growth and spread. Providence Health & Services, Renton, WA. https://oregon.providence.org/forms-and-information/a/ask-an-expert-lung-cancer-growth-and-spread/ (Accessed 7 September 2021)
What are the stages of lung cancer? Medical News Today. Update February 10, 2021. https://www.medicalnewstoday.com/articles/316198#symptoms (Accessed 7 September 2021)
What Is Lung Cancer? American Cancer Society, Atlanta, GA. https://www.cancer.org/cancer/lung-cancer/about/what-is.html (Accessed 7 September 2021)
National Lung Screening Trial. National Cancer Institute, Bethesda, MD. . https://www.cancer.gov/types/lung/research/nlst-qa (Accessed 6 September 2021)
Lung Cancer: Screening. Final Recommendation Statement March 9,2021. U.S. Preventive Services Task Force, Rockville, MD. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening (Accessed 6 September 2021)
Samit J, Evila-Tang E, Rudin C. Lung Cancer In Never Smokers: Clinical, Epidemiology, and Environmental Risk Factors. Clin Cancer Res.2009 Sep 15: 15(18): 5626-5645. (Accessed on PubMed 6 September 2021)
What is radon gas? Is it dangerous? United States Environmental Protection Agency, Washington, DC. https://www.epa.gov/radiation/what-radon-gas-it-dangerous (Accessed 8 September 2021)
The Connection Between Lung Cancer and Outdoor Air Pollution. American Lung Association, Chicago, IL. https://www.lung.org/blog/lung-cancer-and-pollution (Accessed 8 September 2021)
Osteoporosis Fast Facts. National Osteoporosis Foundation, Arlington, VA. https://cdn.nof.org/wp-content/uploads/2015/12/Osteoporosis-Fast-Facts.pdf
Your Medicare Coverage: Lung cancer screenings. Medicare.gov. U.S. Centers for Medicare and Medicaid Services, Baltimore, MD. https://www.medicare.gov/coverage/lung-cancer-screenings (Accessed on 8 September 2021)
. https://www.medicinenet.com/will_a_chest_xray_show_lung_cancer/article.htm
4. Low-Dose CT Scan for Lung Cancer Screenings. Swedish Medical Center, Seattle, WA. https://www.swedish.org/services/thoracic-surgery/our-services/lung-cancer-screening-program/low-dose-ct-scan-for-lung-cancer-screening (Accessed 3 October 2021)
https://www.webmd.com/lung-cancer/guide/lung-cancer-stage-i-overview
Lung cancer among people who never smoked. https://www.cdc.gov/cancer/lung/nonsmokers/index.htm
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