Lung Cancer Screening and Risks: Early Detection Saves Lives

125,000.

That’s the number of people in the U.S. who die from lung cancer each year.

Accounting for about 1 in 5 of all cancer deaths, lung cancer kills more people each year than breast, colon, and prostate cancers combined.

Yet the biggest tragedy is the fact that most lung cancer deaths are preventable.

Lung Cancer Screening Guidelines: Don't Wait for Symptoms

According to Dr. Eduardo Núñez with Baystate Pulmonary Medicine, one of the reasons lung cancer is so deadly is that most people aren't diagnosed until the disease is advanced. “Lung cancer can exist for years without producing symptoms,” he says. “Often when symptoms do develop, they're mistaken for a cough, infection, or just accepted as a long-term effect from smoking. Which is why screenings are key.”

Performed using a low-dose CT scan (LDCT), lung cancer screenings are painless and take just a few minutes. Screenings are recommended for current and former smokers, ages 55-80 years, and especially anyone with a 20+-pack-year history.

Dr. Núñez explains, “You can calculate your pack-year history by multiplying the number of packs smoked per day by the number of years you’ve smoked. So, if you smoked a pack a day for 20 years, you have a 20-pack-year history. If you smoked 2 packs a day for 10 years, you also have a 20-pack-year history.”

Unlike previous screening methods, CT scan can detect cancer in the earliest stages, when it’s highly treatable, often with less aggressive treatments and with fewer adverse side effects. “But,” Dr. Núñez emphasizes, “screenings only work if you get one.”

Causes of Lung Cancer: More Than Just Cigarettes

Most people tend to equate lung cancer with cigarettes, and with good reason.

According to Dr. Núñez, “Eighty to ninety percent of all lung cancers are tied to smoking cigarettes. People who smoke cigarettes have a 30% lifetime risk of developing lung cancer compared to a less than 1% risk in people who don’t smoke.”

Unfortunately, the risk of smoking-related lung cancer doesn’t just apply to smokers. Non-smokers need to consider their lung cancer risk from other factors and get screened as well.

Dr. Núñez says, “Second-hand smoke is associated with a 20 to 30% increased risk of lung cancer. Unlike the choice to smoke cigarettes, second-hand smoke exposure is often out of our hands and often begins much earlier than smoking. Children in homes where there’s one or more smokers often end up being exposed to cancer-causing carcinogens longer than the actual smoker or smokers.”

Lest smokers think that a cigar or pipe is a safe option, Dr. Núñez cautions: “While the risk of lung cancer from cigar- and pipe-smoking is lower than it is with cigarettes, the risk is still two to five times higher than non-smokers. The more you smoke, the greater your risk.”

But even if you’ve never smoked or been exposed to second-hand smoke, your risk is never zero.

Other factors that increase the risk of developing lung cancer include:

Radon: The second leading cause of lung cancer after smoking, radon is a naturally occurring colorless and odorless gas. Present in rock, soil, and groundwater, radon can find its way into basements and homes. Exposure can increase your risk of lung cancer by up to 40%.

As Dr. Núñez notes, “There’s nothing you can do to stop the earth from releasing radon, but you can test for it and get rid of radon. Based on the levels you find, you can invest in mitigation systems that can reduce levels by up to 99%.”

Asbestos: A once highly popular construction material, asbestos still exists in many older buildings and is used in commercial products like automotive parts, roofing materials, and even fertilizer. Exposure to asbestos increases an individual’s risk of lung cancer by 500%. That number climbs dramatically higher if an exposed individual also smokes.

Because of the high risk associated with asbestos exposure, it’s important for anyone who works or has worked in the following industries or trades ask their doctor about getting screened.

Air Pollution: Studies have shown that particle pollution in outdoor air—like that coming from vehicle exhaust, dust, pollen, smoke, wildfires, coal-fired power plants and other industrial sources—can cause lung cancer. While you can’t avoid pollution entirely, you can avoid exposure by tracking pollution levels on your phone using many weather apps or at AirNow.gov.

Dr. Núñez advises anyone with COPD, asthma or severe allergies to speak to their doctor about how best to limit and manage exposure to air pollution.

Know Your Lung Cancer Risk and Take Action

Dr. Núñez urges smokers, former smokers, and anyone at an elevated risk of lung cancer to not get complacent just because they don’t have symptoms.

“I really can’t stress the importance of early detection enough,” he says. “Catching it early can literally add years and quality to your life. The five-year survival rate for early-stage lung cancer is much higher—63%—than the survival rate—8%—for those diagnosed at a late stage.”

For those still hesitant, he encourages them to take a quick online lung cancer risk assessment called ShouldIScreen. Share the results with your doctor and discuss whether or not you should be screened.

And if you're still actively smoking, consider quitting and seek medical help to do so if needed.