Lung Cancer Screening

LDCT lung screening is an easy, noninvasive CT (computed tomography) scan of the lungs. It involves minimal radiation exposure and is performed in just a few minutes. There are no needles or medication involved.

About 25 percent of lung screening exams find something in the lungs that may require additional evaluation. Lung nodules are small collections of tissue and are very common. About 97 percent of nodules found are not cancerous. However, further testing or referral to a specialist may be needed to determine if a nodule is cancer. You should check with your insurance provider to determine coverage for this additional testing.

You may qualify for screening if you:

• Are between the ages of 50 to your 77th birthday;
• Are currently a smoker or have quit within the past 15 years;
• And have a 20-pack-a-year smoking history. For example, this is equivalent to the following:
  • Smoking a pack a day for 20 years;
  • Smoking two packs a day for ten years;
  • Smoking half a pack per day for 40 years.

• Are asymptomatic (no signs or symptoms of lung cancer)

Your primary care provider will verify your eligibility.

As all insurance providers are different, we strongly encourage you to contact your insurance provider to determine if you are covered for LDCT lung screening under your plan. Those with symptoms of a lung condition at the time of screening, such as a new cough or shortness of breath, are not eligible.

Elliot Hospital offers a self-pay option for those patients who may be considered high-risk. The self-pay exam cost is $171.00 which you will be billed later in two separate bills. One from The Elliot for $112.00 and the other from Southern NH Radiology Consultants for $59.00.

High-risk factors:

• Exposure to other cancer-causing agents in the workplace.
• Minimal radiation exposure
• Radioactive ores such as uranium.
• Inhaled chemicals such as arsenic, beryllium, cadmium, silica, vinyl chloride, nickel compounds, chromium compounds, coal products, mustard gas, and chloromethyl ethers
• Diesel exhaust
• Exposure to radon
• Exposure to asbestos
• Personal or family history of lung cancer
• Secondhand smoke

The purpose of CT lung screening is to save lives. Without CT lung screening, lung cancer is usually not found until a person develops symptoms. At that time, the cancer is much harder to treat.

Specific symptoms can signify that you have a condition in your lungs that should be evaluated and treated, if necessary, by your healthcare provider. These symptoms include fever, chest pain, a new or changing cough, shortness of breath that you have never felt before, coughing up blood, or unexplained weight loss. If you have any of these symptoms, please let your healthcare provider know, as CT lung screening is inappropriate and may delay the treatment you need.

It depends. In some cases, CT lung screening will not be appropriate, such as when your doctor is already following your cancer with CT scan studies. Your doctor will help determine if CT lung screening is right for you.

Yes. If you are in the previously described high-risk group and/or have determined with your healthcare provider that CT lung screening is appropriate, a CT lung screening exam is recommended yearly.

Studies have shown that CT lung screening can lower the risk of death from lung cancer by 20 percent in people at high risk.

CT lung screening is one of the most straightforward screening exams you can have. The exam takes less than 10 seconds. No medications are given, and no needles are used. You can eat before and after the exam. You do not need to change if the clothing on your chest does not contain metal. You must, however, be able to hold your breath for at least six seconds while the chest scan is being taken.

There are several risks and limitations of CT lung screening. We want to ensure that we have done a good job explaining these to you, so please let us know if you have any questions. In addition, your healthcare provider who ordered the screening may want to talk with you more about this:

• Radiation exposure: CT lung screening uses radiation to create images of your lung. Radiation may increase a person’s risk of cancer. However, using special techniques, the amount of radiation in CT lung screening is small - about the same amount a person would receive from a mammogram. Further, your doctor has determined that the benefits of the screening outweigh the risks of being exposed to a small amount of radiation from this exam.
• False negatives: No test, including CT lung screening, is perfect. You may have a medical condition that, including lung cancer, is not found during your exam. This is called a false negative.
• False positives/additional testing: CT lung screening very often finds something in the lung that could be cancer but is not. This is called a false positive. False positive tests can cause anxiety. To ensure these findings are not cancer, you may need more tests. These tests will be performed only if you give us permission. Occasionally, patients need a procedure, such as a biopsy, that can have potential side effects.
• Findings unrelated to lung cancer: our CT lung screening exam also captures images of areas of your body next to your lungs. In a small percentage of cases (5 percent−10 percent), the CT scan will show a finding outside of the lung in areas such as your kidneys, adrenal glands, liver, or thyroid, which may require further evaluation. Your healthcare provider who ordered your exam can help determine what, if any, additional testing you may need.

Coverage for CT lung cancer screening may vary among insurance companies. We strongly encourage you to contact your insurance provider to determine if CT lung cancer screening is covered by your plan.

About one out of ten CT lung screening exams will find something in the lung that may require additional imaging or evaluation. Most of the time these findings are lung nodules.

Lung nodules are very small collections of tissue in the lung. These nodules are very common, and the vast majority— more than 97 percent—are not cancer (benign). Most are normal lymph nodes or small areas of scarring from past infections.

Less commonly, lung nodules are cancer. If a small lung nodule is found to be cancer, the cancer can be cured more than 90 percent of the time. That is why we are screening you.

To distinguish the large number of benign (noncancerous) nodules from the few nodules that are in fact cancer, we may need to get more images before your next yearly screening exam. If the nodule has suspicious features (for example, it is large, has an odd shape or grows over time), we will refer you to a specialist for further testing.

You will receive the results of your exam within two weeks. If you do not hear from us within two weeks, please be sure to call us at 603-663-1833.

Yes. Your healthcare provider who ordered your exam will receive a copy of your results.

The best way to prevent lung cancer is to stop smoking. For help on quitting smoking, please call the New Hampshire Tobacco Quitline at 1-800-QUITNOW. If you have already quit smoking, congratulations, and keep it up!

Discuss CT lung screening with your healthcare provider to see if you qualify and to schedule your exam. Please note that we will need an order for CT lung screening from your healthcare provider before your exam.