Lung Cancer Screening

by National Cancer Institute

Lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.

The lungs are a pair of cone-shaped breathing organs inside the chest. The lungs bring oxygen into the body when breathing in and send carbon dioxide out of the body when breathing out. Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes involved in lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

There are two types of lung cancer: small cell lung cancer and non-small cell lung cancer.

Lung cancer is the leading cause of cancer death in the United States.

Lung cancer is the leading cause of cancer death and the second most common nonskin cancer in the United States.

Tobacco smoking is the most important risk factor for lung cancer.

Anything that increases a person's chance of developing a disease is called a risk factor. The main cause of lung cancer is tobacco use, including smoking cigarettes, cigars, or pipes, now or in the past.

There are other risk factors for lung cancer, but even when taken together, their effect on lung cancer is very small compared to the effect of tobacco smoking. These include the following:

• Being exposed to second-hand smoke.
• Being exposed to asbestos, arsenic, chromium, nickel, or other workplace agents.
• Being exposed to radon, which can be found in the home as well as in the workplace.

Lung Cancer Screening

Tests are used to screen for different types of cancer.

Some screening tests are used because they have been shown to be helpful both in finding cancers early and decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.

Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, finding and treating the disease at an early stage may result in a better chance of recovery. Clinical trials that study cancer screening methods are taking place in many parts of the country.

Two tests have commonly been used to screen for lung cancer.

It has not yet been shown that screening for lung cancer with either of the following tests decreases the chance of dying from lung cancer:

Chest x-ray

A chest x-ray is an x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Sputum cytology

Sputum cytology is a procedure in which a sample of sputum (mucus that is brought up from the lungs by coughing) is viewed under a microscope to check for cancer cells.

New tests are being studied in clinical trials.

Spiral CT scan

Spiral CT scan is a procedure that makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path. The pictures are made by a computer linked to the x-ray machine. This procedure is also called a helical CT scan. Screening clinical trials are taking place in many parts of the country.

Risks of Lung Cancer Screening

Screening tests have risks.

Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

The risks of lung cancer screening tests include the following:

Finding lung cancer may not improve health or help you live longer.

Screening may not improve your health or help you live longer if you have advanced lung cancer or if it has already spread to other places in your body.

Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. It is not known if treatment of these cancers would help you live longer than if no treatment were given, and treatments for cancer may have serious side effects.

False-negative test results can occur.

Screening test results may appear to be normal even though lung cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

False-positive test results can occur.

Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy), which also have risks. A biopsy to diagnose lung cancer can cause part of the lung to collapse. Sometimes surgery is needed to reinflate the lung.

Chest x-rays expose the chest to radiation.

Radiation exposure from chest x-rays may increase the risk of developing certain cancers, such as breast cancer.

Your doctor can advise you about your risk for lung cancer and your need for screening tests.

About the Author

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