A low-dose computed tomography (LDCT) screening program designed to detect lung cancer at an early stage in individuals with risk factors such as smoking history and age.
Indication
- Individuals aged 50-80 with a smoking history of 20 pack-years or more
- Current smokers or those who quit within the past 15 years
- Individuals with occupational exposure (asbestos, radon, silica, diesel exhaust)
- First-degree relative with a history of lung cancer
- Follow-up of suspicious nodules detected in previous screenings
- Risk assessment in the presence of chronic lung disease (COPD, idiopathic pulmonary fibrosis)
Preparation
- Generally no special preparation is required; no food or medication restrictions
- Metal jewelry, bras, and clothing with zippers must be removed
- Previous lung images, if available, should be brought for comparison
- Any possibility of pregnancy must be reported in advance
How it's performed
- The patient lies on the back with arms raised above the head
- The lungs are imaged in a single breath-hold
- The procedure takes approximately 5-10 minutes; the actual scan takes only a few seconds
- Significantly lower radiation dose is used compared to standard CT (LDCT)
- Images are evaluated by a radiologist, and nodules are classified according to the Lung-RADS system
- Results are interpreted together with a pulmonologist
Post-procedure
- Annual screening (yearly LDCT) is recommended after a negative result
- If a suspicious nodule is detected, follow-up CT is performed at 3-6 months to monitor growth
- For high-risk nodules, further evaluation with PET-CT or biopsy is considered
- Smoking cessation support is offered at every follow-up
- Information sharing with the family physician for a personalized health plan
Risks
- Additional tests and anxiety due to false positive results
- Cumulative radiation exposure, although at low doses
- Risk of unnecessary follow-ups and interventions for clinically insignificant nodules (overdiagnosis)
- Inability of LDCT to detect some small tumors (false negatives)
- Pneumothorax or bleeding during further investigation involving biopsy (rare)
FAQ
Is the screening CT different from a regular lung CT?
Yes, a low-dose protocol is used; the radiation dose is significantly lower than that of a standard chest CT.
If I have quit smoking, should I still be screened?
Risk may remain elevated for those who quit within the past 15 years; if you meet the appropriate age and pack-year criteria, screening is recommended.
Does screening prevent lung cancer?
Screening does not directly prevent cancer; however, treatment success and survival can be significantly improved through early detection.
Is it covered by insurance?
Coverage conditions vary by year and institution; it is advisable to verify with your social security agency before the appointment.
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