Who Should Be Screened for Lung Cancer

At NYU Langone’s Lung Cancer Screening Program, our team follows the screening guidelines agreed upon by the U.S. Preventive Services Task Force and the Centers for Medicare and Medicaid Services. You may be a candidate for screening if you meet the following criteria:

• are age 50 to 80
• have at least a 20 pack-year smoking history—equivalent to smoking 1 pack a day for 20 years or 2 packs a day for 10 years
• are a current smoker or have quit smoking within the last 15 years
• you have not received a lung cancer diagnosis within the last 5 years

If your doctor recommends screening, our specialized team will confirm your eligibility and help you schedule a low-dose CT scan to look for signs of lung cancer. Our dedicated clinical and administrative staff walk you through the entire process and answer any questions you may have.

It is important to note that CT scans are very sensitive and, in some instances, can pick up “false positives”—abnormalities in the lungs, including small scars or tiny lymph nodes, that are not cancer and are unlikely to ever cause a problem.

If one of these abnormalities is detected, you may need a follow-up CT scan or, less often, a biopsy or other procedure. Any findings from your scan are communicated to your doctor, and our team will work with you to determine the appropriate next steps as needed. In most cases, no cancer is found. To avoid unnecessary tests or procedures, it’s important to only screen people who have an increased risk for lung cancer.

What Increases Risk for Lung Cancer

The single most important risk factor for lung cancer is cigarette smoking. Tobacco use accounts for a majority of all lung cancers. So if you have ever smoked, you have an increased chance of developing lung cancer. The longer you smoke and the more packs of cigarettes you smoke, the greater your risk for developing cancer.

Other factors that may put you at increased risk for lung cancer include the following:

• exposure to radon, a radioactive gas that can exist in homes
• exposure to asbestos, especially if exposure occurred in the workplace
• significant exposure to second-hand smoke, either at home or at work
• exposure to cancer-causing agents in the environment, especially occupational exposures
• lung scarring from certain types of pneumonia or a diagnosis of chronic obstructive pulmonary disease (COPD) or emphysema
• a first-degree relative, such as a parent or sibling, who has had lung cancer

For those who require help to quit smoking, we offer tobacco cessation programs.

Additional Considerations for Screening

The National Lung Cancer Screening Trial, a research study sponsored by the National Cancer Institute and published in 2011, showed that CT screening for lung cancer can save lives. Doctors and patients must weigh risks and benefits. Often, people with a lower risk for developing lung cancer should not be screened because the risks of the screening outweigh the benefits.

Some people have invasive diagnostic procedures as a result of lung cancer screening. While sometimes these tests lead to a diagnosis of cancer, in others, there is no cancer. The diagnostic procedures themselves come with some level of risk, which must be considered before deciding to go through lung cancer screening. Our physicians and nurse practitioners guide you in making the right decision before scheduling your screening.

False-positive results of a low-dose CT scan may cause anxiety and concern even if the result is proven not to be cancer. There is also a chance that you could receive a false-negative result, which happens when cancer is present, but it isn’t detected.

Lung Cancer Screening Research Opportunities

Lung cancer screening saves lives, and our experts at NYU Langone’s Lung Cancer Center, part of Perlmutter Cancer Center, are engaged in research for more effective lung cancer screenings that can help with early and accurate detection of lung cancer.
 
We are currently participating in the following lung cancer screening research initiatives:

• We are conducting research using breath testing to see if we can more easily detect lung cancer through less invasive testing methods. This is done by having you breathe into a balloon to test if the air you exhale correlates with the results of your CT scan.
• We are evaluating whether blood-based screening tests can improve cancer detection.
• We are researching the use of artificial intelligence to examine CT scan images to determine with greater precision whether a lung nodule is cancerous or not. This may result in fewer biopsies and a faster diagnosis.
• We also offer a lung cancer biomarker screening study that involves lung function testing as well as blood and sputum, or spit, testing, in addition to a CT scan.

If you are interested in any of the studies above, please discuss further with our doctors or program staff to determine what may be a good option for you.

Research Study for Nonsmoking Asian Women

Among Asian women with lung cancer, the proportion of nonsmokers is estimated to be as high as 40 percent. The New York Female Asian Nonsmoker Screening Study (NY FANSS) at Perlmutter Cancer Center aims to determine the incidence of lung cancer in nonsmoking women of Asian descent, with the ultimate goal of improving early detection and screening in this high-risk population.

This research study is open to Asian female nonsmokers from age 40 to 74 years. Participants in the study receive up to three free chest CT scans and a blood-based test. This test is being researched for its potential for early detection of lung cancer.

If you meet the criteria and are interested in enrolling, please call 212-731-6212 or email fanss@nyulangone.org.