What to Expect from a Lung Cancer Screening

1. Find out if you are eligible

If you’re concerned about your risk for lung cancer, the first step is finding out if you meet the high-risk criteria for screening. Your doctor can help you determine if you meet the guidelines, which as usually based  on your age, smoking history, and additional risk factors. It is important to know that being recommended for a LDCT does not mean your doctor things you have cancer. Screening is a preventative tool, just like mammograms and colonoscopies and is recommended annually for people at higher risk. 

2. Decide if lung cancer screening is right for you.

During this conversation, you will discuss the benefits and risks of lung cancer screening, how the screening works, what you can expect during and after the scan, and potential outcomes.

The Benefits and Risks:

The main benefit of lung cancer screening is that it can save lives. Lung cancer screening finds over half of lung cancer at an early stage when it is more curable. Without screening, only about 25% of lung cancers are found at an early stage.³

Like other screening tests, lung cancer screening does come with some risks. The LDCT scan uses a small amount, or a low dose, of radiation- about the same as the natural background radiation a person is exposed to over six months by just living on Earth. This amount is slightly higher than the radiation used during a mammogram for breast cancer screenings.¹

Whenever doctors take a detailed look at an organ, like the lungs, they may sometimes find things that look like cancer but are not. These are called false positives. Or the scan might detect slow-growing spots (or nodules) that would never cause you harm during your lifetime. However, because there is no way to know if the cancer will grow or spread, your doctor may recommend care, such as follow-up tests or treatment, that you might not have needed if the scan hadn’t found anything. This is called overdiagnosis.

False positives are not unusual in cancer screening. ² For lung cancer screening, about 12-14% of initial scans result in a false positive. This is similar to the rate seen with mammograms. This rate drops to around 6% with continued annual screenings, as doctors compare your new scan with previous ones to see if anything has changed. 

Thanks to improvements in technology and screening guidelines, the rate of both false positives and overdiagnosis are going down. New tools are helping doctors make better decisions about who needs additional testing and who does not. As lung cancer screening continues to advance, we expect these rates to decline even further.

A LDCT scan also creates images of other parts of the body, not just the lungs. This means that the scan can sometimes detect unrelated things that may be medically important and could require follow-up testing or treatment. These are called incidental findings. About 6 out of 100 (6%) of first-time scans show an incidental finding. Like false positives, this number drops to 2% with continued annual screenings, as doctors become familiar with your baseline scan. Your doctor will talk with you about the chances of false positives, overdiagnosis and incidental findings, and help you understand what to expect is anything unusual shows up on your scan.

3. Scheduling your scan and checking your coverage

If you are eligible for lung cancer screening and decide to move forward, your doctors will place an order for a LDCT scan. Most doctors will tell you where you need to go for your appointment, but if you are unsure where you should get your scan.

Before your scan, it’s a good idea to call your health insurance provider to confirm that your screening is covered. Most insurance plans cover lung cancer screening for people who meet the high-risk criteria, but coverage details may vary. Be sure to ask about any out-of-pocket costs, including possible costs for follow-up tests if something is found on the scan.

4. Preparing for your lung cancer screening

The screening center will give you specific instructions on how to get ready for your scan. Fortunately, it is easy to prepare for a lung cancer screening. Be sure to let your doctor know if you have a respiratory infection (like the cold or the flu), as being sick can affect the results. If you are not feeling well, your scan might need to be rescheduled.

On the day of your appointment, you will be asked to remove any metal items you are wearing, such as jewelry or watches, as these can interfere with the imaging. In some cases, you may be able to stay in your regular clothes, but you might be asked to change into a hospital gown depending on the center’s guidelines.

5. What to expect during the scan.

When you arrive for your appointment, you’ll receive your scan. Lung cancer screenings are quick and easy, usually lasting less than a minute. You’ll lie down on a table that slides in and out of the machine. During the scan, you’ll be asked to lie very still and may be asked to hold your breath for a few seconds to get the clearest images.

A trained technologist will be there to guide you through the entire process, explaining each step and making sure you’re comfortable.

6. After your scan

Once your scan is complete, you can go about your day as usual. Your doctor will review your scan’s results and contact you to discuss what they found and any recommended next steps. 

If you have questions about lung cancer diagnosis, treatment and support resources, visit Lung.org/lung-cancer for reliable information.

7. What happens after your scan?

Your doctor will also discuss what might happen after the scan. If a screening test result is abnormal you might need to have more tests to find out if you have lung cancer. Even if there are no nodules that require follow-up, similar to a mammogram, you will still be asked to come back yearly for a scan. If there is a small nodule, your doctor might recommend you come back for another scan to see if it has grown. If there is a nodule that looks suspicious, your doctor might recommend more testing like a PET scan or a biopsy to find out if it is cancer. If you do have cancer, your doctor will likely recommend treatment which could include surgery, chemotherapy, radiation, immunotherapy or targeted therapies.

An important part of this shared-decision making conversation is helping patients quit smoking. If you currently smoke, your doctor will also counsel you on the importance of quitting smoking and provide you with resources to help you quit.

Your doctor will also talk with you about what to expect after the screening. If the scan results are abnormal, you may need additional tests to find out whether you have lung cancer. However, even if there are no nodules found, you will still be asked to return each year for a routine LDCT. This is because regular screening gives doctors the best chance to catch any changes early.

If a small nodule is found, your doctor may recommend a follow-up scan in a few months to check if it has grown or spread. If the nodule looks more suspicious, you may need detailed testing, such a PET scan or a biopsy, to determine if it’s cancer. If lung cancer is diagnosed, your doctor will talk with you about treatment options, which may include surgery, chemotherapy, radiation, immunotherapy, or targeted therapies.

Another important part of the shared decision-making conversation is supporting you in quitting smoking, if you currently smoke. Quitting smoking, alongside reducing your exposure to other risk factors, is one of the most effective ways to reduce your risk of lung cancer. Your doctor will talk with you about resources and support available to help you quit.