By Bradley Icard, D.O.
When people think about checking their lung health, they often think about symptoms: a lingering cough, shortness of breath or discomfort in the chest. But lung cancer can develop before any of those warning signs appear.
That is why a conversation about screening matters, even when you feel well.
November is Lung Cancer Awareness Month. As a pulmonologist, I want people in our community to understand that we have a proven way to look for lung cancer before symptoms begin. For those who qualify, an annual low-dose CT scan can help find cancer earlier, when treatment is more likely to be successful.
Why finding lung cancer early matters
Lung cancer remains the leading cause of cancer death in the United States. The American Cancer Society estimates that approximately 229,000 people will be diagnosed in 2026 and nearly 125,000 will die from the disease.
One challenge is that early lung cancer often causes no noticeable symptoms. Someone may continue working, exercising and going about daily life without realizing anything is wrong.
Screening offers an opportunity to identify cancer during that quiet period. Research has shown that annual low-dose CT screening can reduce the risk of dying from lung cancer in people at higher risk.
What does screening involve?
A low-dose CT scan uses X-rays to create detailed images of the lungs, with less radiation than a standard CT scan. The scan itself usually takes only a few minutes and does not require an injection. You lie on a table that moves through the scanner and may be asked to briefly hold your breath.
A routine chest X-ray is not a substitute for this screening.
Sometimes the scan identifies a small spot, called a lung nodule. Finding a nodule does not necessarily mean you have cancer. Many nodules are harmless. Depending on its appearance and your medical history, your healthcare team may recommend another scan to monitor it or additional testing.
If a tissue sample is needed, specialists may use bronchoscopy, a procedure that uses a thin scope to examine the airways and obtain samples. The approach depends on the location of the finding and the individual patient.
Screening also has limitations. It cannot detect every cancer, and it can lead to additional tests for findings that turn out not to be cancer. It involves a small amount of radiation. Your healthcare provider can help you weigh those risks against the potential benefit.
Who should ask about screening?
The U.S. Preventive Services Task Force recommends annual low-dose CT screening for adults who:
• Are ages 50 to 80.
• Have a smoking history of at least 20 pack-years.
• Currently smoke or quit within the past 15 years.
A pack-year measures smoking exposure over time. Smoking one pack a day for 20 years, or two packs a day for 10 years, equals 20 pack-years.
The American Cancer Society also recommends annual screening for adults ages 50 to 80 with at least a 20 pack-year history, but its recommendation does not include a cutoff based on how long ago someone quit.
Because recommendations and insurance requirements can differ, ask your healthcare provider about your eligibility and coverage. Your overall health and ability to undergo treatment also matter when deciding whether screening is appropriate.
Leave judgment out of the conversation
A smoking history is medical information. Sharing it openly helps your healthcare team understand your risk and recommend appropriate care.
If you have quit smoking, that is an important step for your health. But quitting does not immediately eliminate lung cancer risk, so it is still worth asking whether screening is right for you.
If you currently smoke, your healthcare provider can offer support to help you quit. Screening and quitting serve different purposes: screening looks for cancer, while quitting helps reduce future risk.
People who have never smoked can also develop lung cancer. Regardless of your smoking history, a persistent or worsening cough, coughing up blood, unexplained weight loss or new shortness of breath deserves prompt medical attention. Evaluating symptoms is different from screening, and you should not wait to meet screening criteria before seeking care.
Start with one question
This November, ask your healthcare provider: “Should I be screened for lung cancer?”
If someone you love has a history of smoking, encourage them to ask, too.
You do not need to calculate your risk on your own or wait until something feels wrong. Start the conversation, share your history and learn what makes sense for you.
Pinehurst Medical Clinic Pulmonologists Bradley Icard, D.O., Michael Pritchett, D.O., MPH, and Adam Belanger, M.D., offer a broad range of comprehensive pulmonology services in Lee and Moore County under a patient services agreement with FirstHealth Pulmonology.
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