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Who should be screened for lung cancer?

Dear Savvy Senior: What can you tell me about lung cancer screenings? My husband was a longtime smoker but quit many years ago, so I’m wondering whether he should be checked out. — Concerned Spouse

Dear Concerned: According to recent recommendations from the U.S. Preventive Services Task Force, an independent panel of medical experts that advises the government on health policies, your husband is at high risk for lung cancer and should talk to his doctor about getting screened if:

■ He’s age 55 to 80;

■ Smokes now or quit within the past 15 years;

■ Has a smoking history of at least 30 pack-years.

Pack years are determined by multiplying the number of packs he smoked daily by the number of years he smoked.

You’ll be happy to know that lung cancer screenings, which are recommended annually to those at risk, will be covered by all private health insurance plans starting in 2015, and Medicare is expected to begin coverage in February or March. The Medicare screening, however, will only cover high-risk beneficiaries through age 74.

Lung cancer kills around 160,000 Americans each year making it the deadliest of all possible cancers. More people die of lung cancer than of colon, breast and prostate cancers combined.

Lung cancer also occurs predominantly in older adults. About two out of every three people diagnosed with lung cancer are 65 or older, and the risk of lung cancer peaks at age 71.


The goal of annual screenings is to detect cancer early before symptoms appear, so it can be cured. The five-year survival rate among people with lung cancer when it’s caught in its earliest stage is 77 percent, versus only 4 to 25 percent for people whose cancer has spread.

To get screened for lung cancer, your husband will need a low-dose computed tomography (CT) chest scan, which is a painless, noninvasive test that generates detailed three-dimensional images of his lungs.

For the screening, he will be asked to lie on a table that slides through the center of a large, doughnut-shaped scanner that rotates around him to take images.

Each scan takes just a few seconds, during which time he’ll be asked to hold his breath, because movement can produce blurred images. The entire procedure takes only a few minutes from start to finish.

Understand that lung CT screening has downsides. First, it exposes you to some radiation — about the same as a mammography but more than that of a chest X-ray.

Lung CT screenings aren’t foolproof, either. They can produce a high rate of false-positive results, which means they frequently detect small spots (abnormalities) on the lungs that are suggestive of cancer but aren’t cancerous. These false alarms lead to more testing and sometimes lung biopsies and unnecessary anxiety.


Because smoking causes 80 to 90 percent of all lung cancer cases, the best way to avoid lung cancer is to not smoke, and if you do smoke, quit. Even if you’ve been a smoker for a long time, quitting now still decreases your risk.

Other factors that can increase the risk of lung cancer include exposure to secondhand smoke, radon, asbestos and other toxic chemicals or fumes.

For more information on lung cancer screenings, call the American Lung Association at 800-586-4872, or use the group’s online tool (lungcancerscreeningsaves-lives.org), which will help you determine whether your husband needs to be screened.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the “Today” show and author of “The Savvy Senior” book.

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