Lung Cancer Screenings | Penn Medicine

When lung cancer is detected in its earliest stages, more treatment options are available that can result in better outcomes. To detect lung cancer early, we offer low-dose CT (LDCT) lung cancer screening. Before low-dose CT scans of the lungs, doctors usually found lung cancer once a person developed symptoms. By the time symptoms typically develop, lung cancer is more progressed and much harder to treat.

The National Lung Screening Trial (NLST) found that lung cancer deaths dropped by 20 percent when people were screened using LDCT scans compared to chest X-rays. Low-dose CT scans for lung cancer allow doctors to find lung cancer sooner, giving you the best chance for successful treatment.

Lung Cancer Screening Guidelines

The U.S. Preventative Services Task Force (USPSTF) recommends LDCT scans of the lungs for adults aged 50 to 80 who:

Have a 20 or more "pack-year" history of smoking. A "pack-year" is the number of packs of cigarettes smoked daily, multiplied by the number of years smoking, such as a pack a day for 20 years or two packs a day for 15 years.
Currently smoke or have quit within the last 15 years.
Suffer from lung conditions such as chronic obstructive pulmonary disease (COPD)
Have a family history of lung cancer
Were exposed to asbestos at work
Have been treated for lung cancer more than five years ago

If you are in a high-risk group, you may need to have a lung cancer screening exam until you reach age 77 or have stopped smoking for 15 years.

You won't qualify for LDCT lung screening if you:

Are in active radiation or chemotherapy treatment
Have had a chest CT scan done within a year (you will need to wait one year to have another screening and will need a prescription)
Have symptoms of a lung condition such as a new cough or shortness of breath

Types of Lung Cancer Screenings

Today, the LDCT screening test is the preferred test for detecting lung cancer, but the final diagnosis of lung cancer is based on viewing lung cells in the lab. These screenings may be from mucus you cough up (sputum cytology), fluid from an area around the lung (thoracentesis), or by using a needle or surgery (biopsy). Your provider will help you determine which test is right for you.

Low-Dose Computerized tomography (LDCT)

The only recommended screening test for lung cancer is the LDCT. During LDCT screening, you will lie on a table and a machine uses a low dose of radiation to make detailed images of your lungs. The scan is painless and only takes a few minutes.

How Low-Dose CT Scan for Lung Cancer Works

LDCT lung screening is one of the easiest screening exams:

You don't have to take any medications
There are no needles involved
It is painless and quick

During the scan:

You will lie on a table that moves through the CT scanner, a large donut-shaped machine.
You will be asked to hold your breath for at least six seconds while the machine scans your chest. Your stillness creates clearer images.
The machine creates images of your chest and lungs that doctors use to detect lung cancers.

Sputum Cytology

A sample of mucus you cough up from the lungs sent to a lab to look for cancer cells. You provide early morning saliva samples 3 days in a row to help find cancers that start in major airways of the lung (e.g., squamous cell lung cancers)

Thoracentesis

A procedure used to see if cancer is spreading to the lining of the lungs and to rule out other conditions like heart failure or infection. During a thoracentesis procedure, your doctor inserts a hollow needle between the ribs to collect the fluid which is checked in the lab for cancer cells.

Biopsy

Needle biopsies use a hollow needle to remove a small amount of tissue which will be analyzed by a pathologist in order to make a diagnosis and help your care team with their choice of anticancer drugs.

What If Your Lung Cancer Screening Finds Cancer?

Finding out you have lung cancer can be difficult. But lung cancer screening increases our ability to find and destroy cancer when it's most treatable. If your screening shows signs of cancer, we will help you get what you need to start treatment fast.

To confirm and add necessary details to your diagnosis, we strive to: