Should you as an ex-smoker have a CT scan to rule out lung cancer?  This is a great question.

A few years ago the National Lung Screening Trial found a reduction in disease-specific and all-cause mortality with lung cancer screening.  THEN the Canadian Task Force on Preventive Health Care AND the U.S Preventive Services Task Force voted in favor of a low-dose lung CT scan in those aged 55-80 who have a 30-pack/year smoking history (like one pack a day for 30 years) and currently smoke or have quit within the past 15 years.  So, we physicians, have been ordering low-dose lung CT scans on appropriate patients.

What were the results?  In a small group of Veterans Health Administration patients, it was found that 97.5% of patients who were told they had an abnormal lung CT DID NOT have lung cancer.

Where does this leave us?  The patient and physician should have a discussion about the risks of a false-positive result (a concerning lung CT with subsequent negative work up) and other harms such as radiation exposure, over-

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diagnosis and incidental non-lung-cancer findings.

Talk to your doctor.  Make a plan.