I want to be screened for lung cancer.
What’s next?
If you have read the material in this web page and have decided that you are concerned about your personal risk from lung cancer and want to be screened, your next step is to contact your personal physician, nurse practitioner or physician assistant and ask for an appointment.
During this visit, they will ask you questions to determine if you are eligible for CT screening by Medicare/Medicaid criteria.
They will ask whether you are between the ages of 55-80 (this may change to ages 50-80 in the near future.
They will ask how many packs of cigarettes you smoked on average and for how many years, in order to determine if you meet the criterion of 30-pack years of tobacco exposure. (This criterion may soon change to 20-pack years.)
They will ask if you are still smoking. If you are, they should offer you advice and assistance in smoking cessation, and it is in your best interest to make a determined effort to quit at that time.
If you have already quit smoking, they will ask when you quit. If you last smoked within 15 years, you will be eligible to have a CT-scan that is paid for by Medicare/Medicaid.
You will also go through a history and physical exam to determine if you have any symptoms of or physical signs of lung cancer. In this circumstance, you should be sent immediately for a diagnostic work-up for lung cancer, rather than screening.
If you have serious co-morbid illness e.g. severe chronic obstructive lung disease, heart failure or other cancer, your caregiver may advise you that you would probably not benefit from screening.
Your caregiver is then obligated to have a shared decision making conference with you, that includes your review of materials from a “decision aid”. The information I have provided to you on this web page is intended to meet the obligation for your to review a decision aid that fulfills all of the information criteria mandated by Medicare/Medicaid.
Once you have passed through all of these check-points, you will be given a prescription to receive a low-dose, non-contrast, spiral CT scan of the chest. It is important that you do not receive a higher dose diagnostic CT scan which would mean more radiation exposure.
You may only have the CT scan done at a center that has received American College of Radiology certification.
There may be a delay in scheduling if there is an active spike of COVID-19 in your community.
At Mount Sinai Hospital in New York City, CT-screening is active, using a protocol to ensure safety of both patients and staff.
There is no special preparation for the exam, no requirement not to eat of drink. There is no need to disrobe. No needle or intravenous fluid is injected.
You will be asked to lie down on a padded bench, facing a large white donut-shaped machine. At the appropriate time, you will be asked to take a deep breath in and briefly hold your breath while the bench moves into and back out of the donut. This takes only a few seconds.
Because the test is so rapid and does not include going into a closed space, there is typically no major anxiety or claustrophobia and hence, no need for sedation
You may be asked to wait a few minutes to be certain that the scan pictures are satisfactory before going home.
In some centers you may be able to wait until radiologists have read your scan and talk with you regarding the results.