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AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care
Lung Cancer Screening Tools for Patients and Clinicians

FOR PATIENTS & THEIR HEALTH CARE PROFESSIONAL

(En Español)

Is Lung Cancer Screening Right for Me? A Decisionmaking Tool for You and Your Health Care Professional

If you have smoked for many years, you may want to think about lung cancer screening (testing) with low-dose computed tomography (LDCT). Before making a decision, you should think about the possible benefits and harms of lung cancer screening.

What are the possible benefits and harms of lung cancer screening with LDCT?

The possible benefits and harms from lung cancer screening represent the “average” effect and may not apply to all healthy current and former heavy smokers.

BENEFIT: Greater chance of not dying from lung cancer

  • If 1,000 people are not screened for lung cancer with LDCT, 21 will die from lung cancer.
  • If 1,000 people are screened once a year with LDCT for 3 years, 18 will die from lung cancer.
  • This means that with LDCT screening, 3 fewer people will die from lung cancer.

BENEFIT: Greater chance of not dying from any cause (not just lung cancer)

  • If 1,000 people are not screened for lung cancer with LDCT, 75 will die from any cause.
  • If 1,000 people are screened once a year with LDCT for 3 years, 70 will die from any cause.
  • This means that with LDCT screening, 5 fewer people will die from any cause.

HARM: False alarms and unneeded additional testing

A false alarm happens when a person has a positive screening test but does not actually have lung cancer.

  • If 1,000 people are screened every year for 3 years, about 356 will have a false alarm.
  • Of these 356 people with a false alarm, 18 will have an invasive procedure such as a biopsy (a tiny piece of lung tissue is removed to test for cancer).
  • Of these 18 people, less than 1 will have a major complication as a result of the procedure, such as bleeding in the lung, a collapsed lung, or an infection.

If you have a positive screening test, but your followup imaging tests and biopsy do not show cancer, you could still get lung cancer in the future. So it is important for you and your health care professional to discuss lung cancer screening every year.

Remember, the best way to lower your chances of dying from lung cancer is to stop smoking.

More than 8 out of every 10 lung cancer cases in the United States are from smoking.

Lung cancer screening should not be done instead of quitting smoking. If you currently smoke, talk to your health care professional or call the nationwide quit line at:

1-800-QUIT-NOW
(1-800-784-8669)

HARM: Radiation Exposure

This includes radiation from screening plus radiation from additional testing. High doses (amounts) of radiation increase a person’s chance of developing cancer.

HARM: Overdiagnosis

Screening may find lung cancer that would not have harmed the person in his or her lifetime.

Finding other things that are not lung cancer:

For example, screening can find heart disease or thickened tissue in the lungs from scarring. Researchers do not know the possible benefits or harms of finding other things about your health through lung cancer screening.

What else should you think about when deciding about lung cancer screening?

  • Lung cancer screening should be done every year until you no longer need to be screened.
  • Lung cancer screening may not be right for you if you develop other major health problems.
  • If you are not willing to have lung surgery, lung cancer screening may not be right for you.
  • Lung cancer screening is not a substitute for quitting smoking.

Insurance Coverage

  • Private insurance plans cover lung cancer screening for people age 55 through 80 with no out-of-pocket costs.
  • Medicare covers lung cancer screening with no out-of-pocket costs for people up to age 77 years who meet other criteria.
  • You and your insurance company will be responsible for the costs of additional tests and treatment after the initial screening test.
What is important to you when deciding?
  Favors Screening Favors No Screening
How important is: Very Important Not Important
Finding lung cancer early when it may be more easily treated?
How concerned are you about: Not Concerned Very Concerned
Having a false alarm?
Having other tests if you have a positive screening test?
Being exposed to radiation from lung cancer screening?
Being treated for lung cancer that never would have harmed you?
Being harmed by the treatments you receive for lung cancer?

Benefits of quitting smoking

  • Lower risk for other types of cancer.
  • Lower risk for heart disease, stroke, and narrowing of the blood vessels outside your heart.
  • Fewer problems with breathing, such as coughing, wheezing, or shortness of breath.
  • Lower risk for other lung disease (such as chronic obstructive pulmonary disease or COPD).

What is your decision about lung cancer screening?

 

AHRQ Pub. No. 16-EHC007-13-A
March 2016