Dr. Jennifer Dallas smiles in a white lab coat.
Dr. Jennifer Dallas

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. Jennifer Dallas, an oncologist at Novant Health Cancer Institute - Mint Hill.

“We need to make lung cancer screening as accepted and important as colonoscopies and mammograms,” Dallas said.

In fact, so few people are screened that Dallas said studies estimate only 3% to 14% of eligible patients undergo screening. As a result, most lung cancer, 79%, is 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 (USPSTF) recently updated its lung cancer screening guidelines. 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, which Dallas said is expected to decrease lung cancer deaths by up to 13% annually, mean lighter smokers and younger patients have more access to screening. This is especially important for women and African Americans, Dallas 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, she 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 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. Dallas 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,” Dallas 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. Dallas 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,” Dallas 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 (CDC). Nonsmokers are also diagnosed at later stages “because they don’t think they can have lung cancer,” Dallas 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.