I passed the 15-year window for annual LDCT screening and want to continue with it nonetheless. Insurance rejects it now but I did it last year through self-pay ($200) with referral from my PCP.
Just wanted to update this old post with new lung cancer screening recommendations. The most current guidelines are summarized on UpToDate: https://www.uptodate.com/contents/image?imageKey=PULM%2F64078. Although there are slight variations between different organizations, most recommend screening for those with at least 30 pack-year smoking history with age at least 55 years old. At the time of this post, Medicare covers lung cancer screening with low-dose CT chest for asymptomatic patients age 55-77, who are either currently smoking or quit within last 15 years, who have smoked at least 1 pack per day for 30 years. Before your first lung cancer screening, you will need to schedule a lung cancer screening counseling and shared decision-making visit with your doctor to discuss the benefits and risks of lung cancer screening. You and your doctor can decide whether lung cancer screening is right for you.
Hi,
It would be best to talk about it with your doctor, as a case to case individual approach is always suitable.
The general recommendation is based on previous experience with screening tests. Even smokers are included in those people who participated, so higher risk groups were represented. The screening test should be able to capture disease at an earlier stage where a curative intervention can be applied. The current information shows that the number of people who develop advanced disease does not decrease with the screening test, and so the numbers who would be expected to die per year are not decreasing despite the application of the screening test.
Hence, there is no clear benefit. There is also an uncertain risk (of how high or how low) regarding the application of radiation yearly as the screening test (currently the CT scan is being touted as the imaging tool for these screening studies) may also promote the development of lung cancer.
Remember this is screening, meaning people who have no symptoms. If you do feel something, then the situation changes. This is also as far as general recommendations go, I think that role of the doctor is to provide information and help the individual patient make a decision. Something similar exists for prostate cancer, the screening doesn’t improve survival, so it is not recommended. But it is offered to men, because it could empower them to make a decision, which is also something very important.