Guidance on CT Lung Cancer Screening

(March 28, 2013)

Lung cancer is the leading cause of cancer death for both men and women in the United States. The five-year survival rate for lung cancer patients is only 15 percent.  Many of us have read in the news about low-dose computed tomography (CT) screening to detect lung cancer.  Recent research from the National Cancer Institute National Lung Cancer Screening Trial (NLST) found that low-dose CT reduced deaths by 20 percent compared to chest X-ray.  This method shows promise for detecting lung cancer in highest risk individuals, who have not yet shown symptoms. However, many questions have surfaced.  How effective is it? Who should get screened?  The American Lung Association has released guidelines to help physicians, their patients and the public in their discussions about lung cancer screening. 

American Lung Association Recommendation on Lung Cancer Screening
Based on the NLST findings, the American Lung Association recommends lung cancer screening with low-dose CT scans for people who meet certain criteria, which include the following: current or former smokers (aged 55 to 74 years), with a smoking history of at least 30 pack-years (that is, an average of a pack a day for 30 years) and with no history of lung cancer. 

The Lung Association emphasizes that chest X-rays should not be used for lung cancer screening. 

The Lung Association recognizes that while low dose CT scans may save lives, screening for lung cancer should not be recommended for everyone as many known and unknown risks may be associated with both the screening and subsequent medical evaluation. 

 The Lung Association report also recommends:

  • Patients should be referred to facilities that have experience in conducting low dose CT scans.
  • These facilities should have multidisciplinary teams that can provide comprehensive follow-up. 
  • Hospitals and screening centers should establish ethical policies for advertising and promoting lung cancer CT screening services.

“The American Lung Association is pleased to endorse this clinical prevention strategy that can save many lives” states Norman H. Edelman, MD, American Lung Association Chief Medical Officer, “However, never starting smoking and quitting smoking is still the best way to prevent lung cancer.”  People having their homes tested for radon is also important, as radon exposure can increase the risk of lung cancer. The Lung Association will continue to fight to reduce tobacco exposure, fight for clean air, and fight to find cures for lung disease such as lung cancer.

The full American Lung Association Report on Lung Cancer Screening and related educational materials are available here.

Support for those with lung cancer
Have you or someone you love been diagnosed with lung cancer? The American Lung Association has launched Facing Lung Cancer: Support from Day One, a new web-based resource designed to guide and support those living with lung cancer and their loved ones during every stage of their disease. Lung cancer is a complex and life-changing disease—but those who are living with lung cancer are not alone. Made possible through a partnership and financial support from Lilly Oncology, Facing Lung Cancer concentrates on the most important information that people affected by lung cancer need from day one of their diagnosis. In addition to providing general lung cancer education, the site allows users to design a customized guide to use during conversations with their lung cancer care team. It also features “Ask the Experts,” a series of interview clips with renowned medical experts.

Additional information and resources on lung cancer