What is my risk of getting lung cancer?
What is my risk of dying from lung cancer?
Multiple “decision aids” available on the internet inform individuals who are eligible for Medicare and Medicaid insurance coverage for lung cancer CT screening that their risk of lung cancer is 2.1%. That implies that the odds are about 1 in 50; 
roughly the chance of picking the ace of spades out of a deck of cards on the first try.
This information is completely wrong. Lung cancer risk is much higher than this for most heavy smokers and ex-smokers. The actual risk is in the range of 10-20% or even higher.
The 2.1% figure comes from a report on the National Lung Screen Trial (NLST) from the National Cancer Institute (NCI) in 2011. It is wrong, because it only measured risk of lung cancer after six years. When NLST published a later report risk had increased to 6.7%, more than three times as high – odds of 1 in 15.
But that answer is also wrong. There is a major problem with NLST. It only screened for two years (3 CT scans).
Researchers at the University of Toronto repeated CT scans ten years after the start of their research and found that 21% had lung cancer; a risk of roughly 1 in 5.
If a person had a previous lung cancer, the risk of a second lung cancer in the next 10 years is approximately 20%.
But that is still not the end of the story. What is the lifetime risk of lung cancer for a smoker or ex-smoker? To my knowledge, there is no research study that has measured this risk. To get an idea of lifetime risk one has to rely on national cancer databases. Review of information from the CPS II study shows that the risk of lung cancer in a Male heavy smoker at age 85 may be 24% or higher.
The bottom line is that, if you are over age 50 and are a heavy smoker, you have a lifetime risk of lung cancer that is high – much higher than 1 in 50. Best evidence shows that your personal risk is between 1 in 10 and may be as high as 1 in 4.
Approximately the chance of randomly picking a diamond out of a deck of cards on the first try.
If you have made the wise decision to stop smoking, your risk will be substantially smaller, but it will remain much higher than that of a person who never was a smoker.
If you do not meet Medicare criteria for screening I.e. you have smoked less than 30 pack years or are younger than 55 or quit smoking more than 15 years earlier you still may be at increased risk of lung cancer compared to one who never smoked.
People who have never smoked, but have had heavy exposure to second hand smoke, asbestos, radon gas or some industrial chemicals may also have increased risk of lung cancer.
What is the chance that I will die, if I am unlucky and get lung cancer, if I am not screened for early detection?
The chance of cure in a person who has not participated in CT screening and is diagnosed with lung cancer, in the United States today, is below 20%. That is, the odds of dying of lung cancer are higher than 4 in 5.
How dees CT screening increase the chance of cure and lower the risk of dying from lung cancer?
How does CT screening increase the chance of cure of lung cancer?
