Lung Cancer Screening
Lung cancer is the leading cause of cancer-related death in the USA. Annually, it kills more patients than the next three most common cancers (breast, prostate and colon) combined.
The physicians at Hennepin County Medical Center are pleased to offer at risk patients lung cancer screening with low radiation dose computed tomography (CT) scans.
We recognize the significant anxiety that screening may cause. We therefore offer real-time results of this test to our patients if they desire.
While lung cancer screening may provide health benefits, it is not a substitute for smoking cessation. For those patients who continue to smoke, we also offer counseling, treatment, and referral services to help quit smoking.
If abnormal findings are present on screening CT, a referral will be made to a team of specialists for further evaluation.
Goal: To find lung cancer early, before it has a chance to grow or spread, and to increase likelihood of successful treatment.
Who should be screened?
CT screening has been proven to work only in carefully selected patients. Based on published guidelines from NCCN we recommend you consider screening if you meet the following criteria:
- Age 55-79 years
- 30 pack years of smoking (one pack per day for 30 years, 2 packs per day for 15 years etc.)
- Quit smoking less than 15 years
If you are younger or have smoked less, you may also qualify for screening if you have additional risk factors for lung cancer including history of chronic obstructive lung disease (COPD), a family history of lung cancer, or a personal history of other smoking-related cancer (eg, head and neck, esophageal, or bladder cancer). In these circumstances, a conversation with your health care provider would be recommended to decide if lung cancer screening is right for you.
The screening test should be postponed if you have had a respiratory infection requiring antibiotics within last 12 weeks.
You should not undergo a CT lung screening test if you are dependent on oxygen at baseline.
What is the benefit of screening?
When done properly, lung cancer screening with CT scans has been shown to decrease the likelihood of dying from lung cancer. If lung cancer can be diagnosed earlier, this may allow for better treatment options including surgery to remove the cancer before it spreads.
National guidelines have recommended ongoing annual screening in at risk individuals until they have stopped smoking for 15 years, or they attain the age of 80 years.
Please remember that smoking cessation at any time is associated with significant heath benefits including a reduction in the risk of cancer. If you currently smoke, we strongly recommend you quit.
What are the drawbacks of screening?
- Radiation exposure: We are committed to using the lowest radiation dose possible in all imaging studies. A screening CT exposes you to a very low dose of radiation, approximately the background radiation exposure we all have over the course of 3-4 months. The risk from such a low dose is believed to be minimal.
- False positive results: Small nodules are very common and usually do not indicate a cancer. Up to 40% of patients have at least one nodule on the initial scan and about 95% of these nodules turn out not to be cancer. We have established clear guidelines to make sure all nodules get appropriate follow-up.
- False negative results: While proven to be quite effective, CT scans will NOT find all cancers, or prevent all cancer related deaths.
- Complications from work up and testing: If an abnormality is found, additional diagnostic testing may be recommended. Some of this testing is invasive and may carry risk of complications. With a careful multidisciplinary and collaborative approach, we are committed to minimizing the risk of such complications.
Making an appointment
Discuss the test with your health care provider, who can help you determine if it is appropriate for you. Once your health care provider places and order for the screening CT, you can call radiology at 612 873-2065 to make your appointment.
If your provider is not affiliated with HCMC, they can fax an order to 612 630-8284. You can then call Radiology at 612 873-2065 to set up your appointment.
If you would like to obtain screening, but do not have a health care provider, please call radiology at 612-873-2065. We will help you set up a medical record number, and ask you a few questions to decide if the test is right for you. We can then schedule the exam for you.
If you have had previous chest x-rays or chest CT scans at an outside hospital or clinic, please bring copies with you to the appointment. Comparison between the screening CT and prior studies can be very helpful in avoiding unnecessary imaging or testing.
You may eat and drink as normal before the scan, and take the medications that you might usually take.
Please arrive 15 minutes before your scan.
Please dress in comfortable clothing. If there is metal in your clothing (such as bra or zipper) you may be asked to change into a hospital gown. You may be asked to remove metallic jewelry if it is in the scan field.
What does it cost?
As most insurers do not cover lung cancer screening at this time, you will be charged $99 for the test. This represents a substantial discount from the cost of traditional chest CT scans. Please remember that all patients will be required to prepay by cash, check or credit/debit card before the scan or it may be necessary to reschedule the scan.
If abnormalities are found that require further imaging or other testing, this would normally be covered by medical insurance.
What is the scan like?
You will lie down on the scanner, which is a large machine with a hole in the center. Your caregiver will be able to see you and speak with you at all times. You will be asked to hold your breath. The scan itself will take just a few seconds.
It is critical that you lie still and hold your breath during the scan, or important findings may be missed.
What about my results?
A unique aspect of HCMC’s lung cancer screening program is our ability to provide you with real-time results.
At the time of your scheduling, please let us know if you want to receive the results of your test right away. In this case, we will schedule your screening test during specific times where radiology health care providers are available to discuss your scan results, and make appropriate recommendations. The results will be available about 30 minutes of the scan having been completed. Counseling and assistance in quitting smoking can also be discussed at that time.
If you prefer not to wait, we can schedule the scan on regular weekdays 7-4 PM, and mail the results to you within 2 working days after your scan.
If your scan is abnormal and potentially concerning for cancer, you will be immediately referred to a multidisciplinary team for further evaluation and treatment. Throughout this process, we are committed to providing you with timely, thorough, and compassionate care.
How often do I need to be screened?
If your first scan is negative, you will need annual scans with low dose technique.
If my scan is negative, can I continue smoking?
Absolutely not, the last thing we want is to provide false reassurance to you if you smoke. Smoking has countless harmful effects on your body, and lung cancer is only one of them. Quitting smoking is often the single best thing you can do for your health. We will be glad to help you in any way possible.