Lung Cancer Screening
Lung cancer is one of the most common forms of cancer in the United States, and the leading cause of death from cancer. Often, lung cancers grow silently for many years and reach an advanced stage before causing symptoms that lead to diagnosis and treatment.
Until recently, no screening test for lung cancer has proven effective in detecting tumors at an early, more treatable stage.
The National Lung Cancer Screening Trial
The National Lung Cancer Screening Trial (NLST) is a national cancer screening trial sponsored by the National Cancer Institute (NCI) and conducted by the American College of Radiology Imaging Network (ACRIN) and the Lung Cancer Study Group.
The trial compared two methods of detecting lung cancer:
- Standard Chest X-ray
- Low-dose Helical (Spiral) Computed Tomography (CT)
The trial included more than 53,000 “heavy smoker” adults at 33 sites throughout the country. Each participant was either a former heavy smoker within the last 15 years or a current smoker with at least a 30-pack year history of smoking*.
Between 2002 and 2007, these individuals were randomly assigned to receive either a standard chest X-ray or a helical CT scan annually for three years.
*"Pack years" is a term used to categorize smoking history. To calculate smoking pack years, multiply the number of packs smoked each day times the years of smoking. For example, a person who has smoked two packs per day for 15 years has a 30-pack year smoking history.
Northwestern Memorial Hospital & the NLST
Northwestern Memorial was the only NLST site in Chicago. Eric M. Hart, MD, an attending radiologist at Northwestern Memorial Hospital and Associate Professor of Radiology at Northwestern Feinberg School of Medicine, was the principal investigator for the NLST at Northwestern Memorial.
More than 400 adult smokers between the ages of 55 and 74 years were enrolled in the NLST at Northwestern Memorial. These participants were assigned randomly to receive one of the two screening techniques for three years, followed by monitoring for the next five years.
Results of the NLST
The results, published in August 2011, showed a statistically significant benefit for the study participants who were screened using helical CT. There were 20 percent fewer lung cancer deaths among the individuals at high risk for lung cancer who had been screened with CT scans as compared with those who were screened with standard chest X-rays.
The NLST is the first scientific study that provides clear evidence of an effective screening technique that significantly reduces death due to lung cancer in heavy smokers.
Reducing Your Risk for Lung Cancer
If you are a current smoker, the most important way to reduce your chances of getting lung cancer is to stop smoking. Tobacco use causes:
- Lung cancer
- Chronic lung disease
- Cardiovascular disease
The longer you continue to smoke, the higher your risk for developing one of these diseases. If you stop smoking, damage from tobacco may be partially reversible.
At Northwestern Memorial, we offer smoking cessation classes to help you quit smoking.
For more information about group or individual programs, visit our Smoking Cessation Services Available page.
Should All Smokers Get a CT Scan to Screen for Lung Cancer?
Based on the NLST results, individuals in one or both of the following categories are at high risk for lung cancer and will benefit from CT scan screening:
- Men and Women between the ages of 55 and 75 years
- Current or former heavy smokers (≥30 pack years)
If you think you are a candidate for a CT scan to screen for lung cancer, please talk with your doctor about the potential benefit of CT screening for your particular circumstance. Important factors to consider include:
- Medicare and other insurers do not pay for CT lung cancer screening at this time
- Screening CT scans do not find all lung cancers
- CT scans in current or former smokers often show abnormal areas (such as scar tissue or inflammation) that are suspicious for lung cancer and require additional testing to make an accurate diagnosis
- It is important to contact your doctor if you have any worrisome signs or symptoms, such as an unexpected weight loss of more than 15 pounds, persistent respiratory infection or coughing up blood
For more information about the National Lung Cancer Screening Trial, visit the National Cancer Institute website.
If you are concerned about lung cancer or other lung diseases, please contact your physician to discuss ways to reduce your risk and whether you should undergo lung cancer screening with a low-dose helical CT scan.
If you do not have a physician, you may request an appointment with one of our physicians at Northwestern Memorial Hospital by calling our Physician Referral Service at 1-312-926-LUNG (5864). You may also request a first time appointment online.