Information about lung cancer and screening

Click on a topic below to learn more.

Lung cancer

Lung cancer is a disease in which normal cells of the lung begin growing uncontrollably, becoming cancerous. There are two major types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The majority of lung cancers (85%) are NSCLC. When lung cancer has spread to both lungs, to fluid in the area around the lungs, or to another part of the body, it is called metastatic or advanced lung cancer.
More information about lung cancer and its diagnosis and treatment can be found at these sites:
NCI − General Information About Non-Small Cell Lung Cancer
http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/Patient
NCI − General Information About Small Cell Lung Cancer
http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/Patient

Signs and symptoms of lung cancer

The signs and symptoms of lung cancer vary from person to person. Symptoms can take years to develop and they may not appear until the disease is advanced.
Lung cancer symptoms may include:
  • Intense or persistent coughing
  • Coughing up blood
  • Wheezing
  • Shortness of breath
  • Changes in the voice or being hoarse
  • Harsh sounds with each breath
  • Pain in the chest, shoulder, or back unrelated to pain from coughing
  • Recurrent lung problems, such as bronchitis or pneumonia
  • Unexplained weight loss
  • Fever
  • Fatigue
  • Trouble swallowing
  • Swelling in the face or neck
Most of the time these symptoms are not lung cancer, but it's important to see your doctor to be sure.

Risk factors for lung cancer

Lung cancer is caused by damage to cells of the lung. Several factors can damage lung cells, increasing the risk that they become cancerous:
Smoking
The single most important risk factor for lung cancer is smoking. In smokers, the risk of lung cancer is 10 to 30 times greater than in people who have never smoked. The more cigarettes you smoke, the longer you have smoked and the earlier you started smoking, the greater your risk of developing lung cancer. Smoking cigars or pipes is also associated with an increased risk of lung cancer. People who quit smoking have a lower risk of lung cancer than if they had continued to smoke, but their risk is higher than the risk for people who never smoked. Quitting smoking at any age can lower the risk of lung cancer.
More information about the health risks of smoking can be found here:
http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation
For help quitting smoking, visit our resources page here.
e-Cigarettes
Electronic cigarettes or "e-cigarettes" are battery-powered devices designed to look and feel like cigarettes. They contain nicotine, although the amount of nicotine inhaled from smoking an e-cigarette is not known. Studies have shown that e-cigarettes can cause short-term lung changes that are much like those caused by regular cigarettes, but long-term health effects are still unclear. The safety of e-cigarettes is currently unknown.
More information about e-cigarettes can be found here:
http://smokefree.gov/e-cigarettes
Asbestos
Asbestos is a type of fiber that was commonly used for building insulation and in ship construction until the 1970s. People who have inhaled large amounts of asbestos dust, because they work or worked in industries that use asbestos, have more than three times the risk of developing lung cancer as people who have not worked with or around asbestos. Asbestos exposure is also associated with an increased risk of other types of cancer and other lung diseases. Many uses of asbestos are now banned, but people who have worked in shipyards, building construction, insulation, plumbing, steamfitting, drywall or sheetmetal work, or asbestos mining may have inhaled large amounts of asbestos dust.
More information about asbestos exposure and health risks can be found here:
http://www2.epa.gov/asbestos
Radon gas
People who have been exposed to high levels of radon gas have an increased risk of developing lung cancer. Radon is a naturally occurring element and the most common source of exposure to radiation for most people. Radon gas is found in the air outdoors and indoors. Levels of radon gas vary from place to place. Radon exposure is a particular concern for people who work in mines.
More information about radon gas, including radon levels where you live, can be found here:
http://www.epa.gov/radon
Secondhand smoke
Secondhand smoke (also called environmental tobacco smoke, involuntary smoke, and passive smoke) is the smoke given off by a burning tobacco product and the smoke exhaled by a smoker. Secondhand smoke increases the risk of lung cancer in people who do not smoke. Living with a smoker increases a nonsmoker's chances of developing lung cancer by 20 to 30 percent.
More information about the risks of secondhand smoke can be found here:
http://www.cancer.gov/cancertopics/factsheet/Tobacco/ETS
Air pollution
People who live in places with high levels of outdoor air pollution have a great risk of developing lung cancer than people who live in places with less air pollution. The risk of lung cancer associated with air pollution is lower in the US than in other countries with higher levels of air pollution.
Radiation to the breast or chest
People who have had radiation to the breast or chest to treat another condition, such as breast cancer, Hodgkin's disease, lymphoma or thyroid cancer, have an increased risk of developing lung cancer.
Family history of lung cancer
Having a first-degree family member (a parent, sibling or child) with lung cancer roughly doubles the risk of developing lung cancer. This risk is more for women and less for men and stronger in nonsmokers than smokers. Having a second-degree relative (an aunt, uncle, niece or nephew) with lung cancer raises your risk by around 30%.
Genetics
Scientists are studying the relationship between specific genes and the risk of developing lung cancer. There is currently no genetic test to predict who will get lung cancer or who is at especially high risk.
HIV/AIDS
People infected with the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS) are about three times more likely to be diagnosed with lung cancer than people who don't have HIV, even after accounting for smoking. People with HIV who develop lung cancer are typically much younger than people without HIV who develop lung cancer. Lung cancer may take longer to diagnose in people with HIV, because they are younger and they may have frequent lung infections than people with lung cancer symptoms who do not have HIV.

Race/ethnicity and lung cancer

In men, black men have the highest risk of developing and dying of lung cancer. In women, white women have the highest risk of developing and dying of lung cancer. Differences in the risk of lung cancer between people of different races or ethnic backgrounds are often due to differences in smoking. However, even in people who smoke, there may be racial or ethnic differences in the risk of developing lung cancer. These differences may be due to factors such as differences in metabolism of nicotine and metabolism of tobacco carcinogens. Further research is needed to understand why people of different races and ethnic backgrounds have different risks of developing lung cancer.
More information about race/ethnicity and lung cancer be found here:
http://www.cdc.gov/cancer/lung/statistics/race.htm

Recommendations for screening

The US Preventive Services Task Force recommends annual screening for lung cancer with low-dose computed tomography (low-dose CT) in adults aged 55 to 80 years who have smoked for at least 30 pack-years and currently smoke or who have quit within the past 15 years.
The following recommendations by other expert groups might also be helpful when considering your decision to be screened for lung cancer.
  • The American Cancer Society
    If you are 55 to 74 years old and have smoked for 30 or more pack-years, and either currently smoke or have quit within the past 15 years, lung cancer screening with low-dose CT may be appropriate for you. Before you decide whether to begin screening, you should talk to your doctor about the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose CT.
    http://www.cancer.org/healthy/informationforhealthcareprofessionals/ acsguidelines/lungcancerscreeningguidelines/index
  • The American Lung Association
    If you are 55 to 74 years old and have smoked for at least 30 pack-years, lung cancer screening with low-dose CT is recommended for you.
    http://www.lung.org/lung-disease/lung-cancer/lung-cancer-screening-guidelines/
  • The National Comprehensive Cancer Network
    If you are 1) 55 to 74 years old with at least a 30 pack-year smoking history and currently smoke or have quit within the past 15 years; or 2) 50 years or older with at least a 20 pack-year smoking history and have one additional risk factor, lung cancer screening with low-dose CT is recommended for you.
    http://www.nccn.org/patients/guidelines/lung_screening/index.html
  • The American College of Chest Physicians, American Society of Clinical Oncology and American Thoracic Society
    If you are 55 to 74 years old and have smoked for 30 or more pack-years, and either currently smoke or have quit within the past 15 years, lung cancer screening with low-dose CT may be an appropriate option for you. Before you decide whether to begin screening, you should talk to your doctor about the potential benefits, limitations, and harms associated with low-dose CT screening for lung cancer.
    http://jama.jamanetwork.com/article.aspx?articleID=1163892

Cost of lung cancer screening

The cost of low-dose CT for lung cancer screening depends on your insurance coverage and your personal risk factors. If you ...
... are enrolled in a plan through a state health insurance exchange
You are eligible to receive full coverage for the cost of a yearly low-dose CT for lung cancer screening if you are 55-80 years old with at least a 30 pack-year smoking history, and either currently smoke or have quit within the past 15 years. If something abnormal is found on your CT scan, the additional costs of follow-up tests and procedures may also be covered by your health plan. Check with your insurance provider and the facility performing the CT scan to learn about what is covered and what other costs you might have to pay.
https://www.healthcare.gov/preventive-care-benefits/
... receive health insurance through your employer
Most private plans will cover the full cost of a yearly low-dose CT for lung cancer screening if you are 55-80 years old with at least a 30 pack-year smoking history, and either currently smoke or have quit within the past 15 years. Call your insurance carrier to make sure. If something abnormal is found on your CT scan, the additional costs of follow-up tests and procedures may also be covered by your health plan. Check with your insurance provider and the facility performing the CT scan to learn about what is covered and what other costs you might have to pay.
... receive Medicare benefits
Effective February 5, 2015, Medicare will cover annual screening for lung cancer with low-dose CT if you are 55-77 years old with at least a 30 pack-year smoking history, and either currently smoke or have quit within the past 15 years. To receive coverage, you must receive a written order for low-dose CT screening during a lung cancer screening counseling visit with your doctor or other qualified practitioner. This visit, for counseling and shared decision making, is covered for all Medicare beneficiaries. Check with your insurance provider and the facility performing the CT scan to learn more about what is covered and what other costs you may have to pay.
http://www.medicare.gov/coverage/lung-cancer-screening.html
... receive Medicaid benefits
Medicaid benefits are different in different states. In some states lung cancer screening may be covered. Call your state Medicaid office to find out what is covered in your state.
  • In New York, Medicaid will cover annual screening for lung cancer with low-dose CT if you are 55-80 years old with at least a 30 pack-year smoking history, and either currently smoke or have quit within the past 15 years.
... do not have health insurance
The cost for a low-dose CT scan for lung cancer screening can vary widely at different centers, and prices range from $250 to $500. Many hospitals and radiology centers offer lung cancer screening at a low or reduced cost for qualifying patients.

Lung cancer information and support

There are a number of resources available if you or a loved one is facing lung cancer, or if you would simply like to learn more about the disease.
Resources and support on the web:
MyLungCancerSupport.org
Facing Lung Cancer: Support From Day One, a website created by the American Lung Association, provides educational, interactive resources about lung cancer and treatment options and offers support for patients and caregivers.
LungCancerOnline.org
Lung Cancer Online, a website maintained by the Lung Cancer Alliance organization, is a directory of information and resources on lung cancer, and serves as a reliable reference guide for those diagnosed with lung cancer, their loved ones, healthcare professionals and anyone looking for in-depth information.
FreeToBreathe.org
The website of Free to Breathe, a non-profit organization dedicated to lung cancer patients, includes information about lung cancer, treatment, financial assistance and patient support.
LungCancer.org
Lungcancer.org is a service of CancerCare®, a non-profit organization providing free, professional support - including counseling, support groups, financial assistance, educational workshops and publications - to anyone coping with lung cancer. This website is also available in Spanish.
Cancer.gov
The website of the National Cancer Institute (NCI) offers information about many types of cancers, including lung cancer. The NCI's online and printable booklet, What You Need To Know About™ Lung Cancer, provides information about lung cancer types, staging, treatment, and questions to ask your doctor.
Cancer.org
The website of the American Cancer Society provides facts and resources about lung cancer, treatment options and support groups.
nccn.org/patients
The website of the National Comprehensive Cancer Network, an alliance of leading cancer centers across the US, offers in-depth guidelines and information about several types of cancer, including lung cancer.
Resources and support by phone:
American Lung Association HelpLine
1-800-586-4872 (1-800-LUNGUSA)
The American Lung Association's helpline staff can help answer your questions about lung health, including information about lung cancer, medications and smoking cessation. This free service is open 7 days a week, 7 a.m. to 11 p.m. (Central Time).
Lung Cancer Alliance HelpLine
1-800-298-2436
Health professionals at the Lung Cancer Alliance HelpLine provide information and direction for anyone with questions about lung cancer, as well as provide referrals to national and local resources. The toll-free helpline is open Monday through Friday, 9 a.m. to 5 p.m. (Eastern Time).
CancerCare Support Line
1-800-813-4673 (1-800-813-HOPE)
CancerCare's professional oncology social workers provide free emotional and practical support for people with lung cancer, caregivers, and their loved ones. Counseling is available over the phone or in-person at one of the offices in New York City, Long Island, New Jersey, and Connecticut.
American Cancer Society Information HelpLine
Toll-free number: 1-800-227-2345
The American Cancer Society's trained Cancer Information Specialists provide accurate, up to date information and can answer any of your questions 24 hours a day, every day of the year.
National Cancer Institute Information HelpLine
1-800-4-CANCER (1-800-422-6237)
The National Cancer Institute's information specialists are available to help answer cancer-related questions for patients, family members, friends, health care providers, and researchers. The service is available in English and Spanish, and is open Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.