It’s widely accepted that key screenings like mammograms can detect cancer early, when outcomes are better, and treatment is less invasive. But despite being the third most common cancer in the U.S., lung cancer screening isn’t nearly as common, said Dr. Garrett Sherwood, an oncologist at Novant Health Cancer Institute - Forsyth in Winston-Salem.

Dr. Garrett Sherwood
Dr. Garrett Sherwood

“We need to make lung cancer screening as accepted and important as colonoscopies and mammograms,” said Sherwood, who specializes in treating lung cancer.

In fact, only 5.8% of eligible patients were screened for lung cancer in 2021, the American Lung Association reports. As a result, Sherwood said, most cases are diagnosed in advanced stages when it has already spread to other parts of the body.

When and how to get screened for lung cancer

In an effort to save more lives, the U.S. Preventive Services Task Force updated its lung cancer screening guidelines in 2021. The USPSTF now recommends that current smokers (or those who have smoked within the past 15 years), with a 20-pack per year smoking history, get screened annually from age 50 to 80. The last recommendation from 2013 suggested people with a 30-pack per year smoking history be screened annually from 55 to 74 years old.

The new guidelines increase access to lung cancer screenings for lighter smokers and younger patients. This is especially important for women and African Americans, Sherwood said, as these groups can develop cancer at an earlier age and with a lower packs-per-year history. The highest incidence of lung cancer is in African Americans – with Black men experiencing the highest mortality, he added.

People who are eligible should talk with their primary care physician to get referred for a lung cancer screening, which is covered by most insurance and Medicare plans. The patient will undergo a low-dose CT scan, or computed tomography scan, which yields a more detailed picture of the lungs than a normal X-ray. It is quick – less than 10 minutes – painless and involves no downtime.

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‘Nobody deserves lung cancer’

One of the hurdles to normalizing lung cancer screening has to do with the stigma associated with having it. Sherwood said some people are of the mindset that if they’ve smoked, they’ve done it to themselves.

“No matter what they’ve done, nobody deserves lung cancer,” he said. “Smoking is very addictive and I feel like people have been targeted by the tobacco companies. They have modified the amount of nicotine in cigarettes to make them more addictive. It’s hard to walk in someone’s shoes and how they got to that, but we can’t deny people care or compassion because of that.”

E-cigarettes, often marketed to younger people, can also cause lung cancer. Sherwood said many high school-aged kids have taken up the habit since they are flavored, more inconspicuous and easier to hide. However, e-cigarettes are not safe and contain even more nicotine than cigarettes.

“Vaping is an expensive hobby and a lot of times, people switch to cigarettes because they’re cheaper,” he said.

Even nonsmokers can get lung cancer

Between 20,000 and 40,000 lung cancers each year occur in people who have never smoked or smoked fewer than 100 cigarettes in their lifetime, according to the Centers for Disease Control and Prevention.

Nonsmokers are also diagnosed at later stages “because they don’t think they can get lung cancer,” Sherwood said. Symptoms of lung cancer are the same for people who smoke and those who do not.

Some may have general symptoms of not feeling well or being tired all the time. The CDC said other symptoms include:

  • Coughing frequently.
  • Coughing up blood.
  • Chest pain.
  • Wheezing.
  • Shortness of breath.

Other than smoking cigarettes, risk factors include a family history of lung cancer, secondhand smoke, air pollution, and exposure to either asbestos or radon. Nonsmokers can lower their risk for lung cancer by getting their home tested for radon, a naturally occurring radioactive gas.