Oncologists Urge Women Over 50 to Consider Low-Dose CT Scans for Lung Cancer Screening
Key Insights
Low-dose CT scans can reduce lung cancer (search)-related mortality by 20%, with stage I survival rates above 70% compared to less than 10% for stage IV disease.
The USPSTF recommends annual LDCT screening for adults aged 50–80 with a 20-pack-year smoking history who currently smoke or quit within the last 15 years.
Lung cancer (search) kills more women annually than breast, ovarian, and uterine cancers combined, yet screening awareness among eligible women remains low.
A growing chorus of oncologists is urging women over 50 to look beyond mammography and consider a screening test that could detect the deadliest cancer in the United States: a low-dose CT (LDCT) scan for lung cancer (search). While breast cancer (search) awareness campaigns have successfully embedded mammography into the cultural conversation around women's health, experts warn that this focus has created a blind spot for other malignancies.
"Breast cancer (search) screenings and mammograms have been part of the cultural conversation around women's health for decades," said Dr. Rahul Gosain, MD, MBA, co-host of The Oncology Brothers. "That mainstream visibility has saved many lives, but it's also created a blind spot. Women over 50 face meaningful risk from a range of other cancers, and many of those screening tools are just as effective, just as accessible and far less utilized."
Dr. Daniel J. Boffa, MD, a professor of thoracic surgery at Yale School of Medicine, underscored the broader cancer risk women face. "If you think about all of the women who lose their battle with cancer each year, two-thirds are from cancers other than breast cancer (search)," he said.
The Case for Lung Cancer (search) Screening
Lung cancer (search) remains the leading cause of cancer death in the U.S. for both men and women. Dr. Gosain noted that it "kills more women each year than breast, ovarian and uterine cancers combined."
The numbers behind LDCT screening are compelling. Dr. Richard Reitherman, MD, Ph.D., a board-certified radiologist and medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center (search), pointed to data showing that LDCT screening reduces lung cancer (search)-related mortality by 20%. Furthermore, cancers detected at stage I have survival rates above 70%, compared to less than 10% for stage IV disease.
"This is like the benefit of screening mammography and reduction of mortality," Dr. Reitherman said.
Who Qualifies for Screening
The United States Preventive Services Task Force currently recommends annual LDCT screening for adults aged 50 to 80 years who have a 20-pack-year smoking history — roughly equivalent to one pack a day for 20 years — and who currently smoke or have quit within the last 15 years.
Dr. Boffa emphasized that eligibility criteria may evolve. "The screening guidelines may change, so we recommend that patients who are 50 or older, who smoked in the past or are still smoking, ask their primary care clinician about screening," he said.
What the Scan Reveals
A low-dose CT scan is a radiology test that captures images of "everything inside your chest, from the tops of your shoulders, to just above your belly button," Dr. Boffa explained. While its primary purpose is detecting lung abnormalities, including cancers or pre-cancerous growths, the scan can also identify changes in the heart such as artery hardening (atherosclerosis) and blood vessel enlargement including aneurysms.
"The scan also commonly catches the top part of your abdomen and may pick up abnormal areas in the top of your liver and adrenal glands," Dr. Boffa added. The term "low dose" refers to the reduced radiation used compared to a standard CT scan — roughly equivalent to the radiation exposure on a round-trip flight from New York to California.
Risks and Practical Considerations
Dr. Gosain acknowledged that the risks of LDCT screening are "real but manageable." The main concerns include false positives — such as nodules caused by old scars or healed infections that require additional imaging but prove benign — as well as limited radiation exposure and potential anxiety from the testing process.
"The risk of the scan itself causing cancer is minimal, and for anyone who qualifies for screening, the benefit of early detection vastly outweighs it," Dr. Gosain said. He stressed the importance of undergoing screening at an accredited facility with a shared decision-making conversation with a physician, "so you go in with clear expectations about what a positive result does and doesn't mean."
What Patients Can Expect
The LDCT procedure is notably straightforward. According to Dr. Reitherman, patients can expect no need for contrast — meaning no IV or oral tablets — no fasting requirements, no sedation or anesthesia, and a total procedure time of approximately 10 minutes, including getting on and off the table.
Dr. Gosain added that patients will be asked to remove metal objects such as watches and jewelry before the scan. "Comfortable, loose clothing is suggested as you may be asked to change into a gown, but you more likely won't need to. You can eat and drink normally beforehand and take all your regular medications as usual."
Results are typically delivered via patient portals, mail, or email, with recommendations for follow-up that may include repeating the scan in one year, repeating in six months, or consulting a doctor for further testing.
Dr. Boffa emphasized the importance of expert interpretation. "It is very important to review results with someone who is a part of a lung cancer (search) screening program," he said. "We breathe in a lot of things that can cause changes in our lungs, so it is not surprising to find abnormalities on the CT scan, but most of the abnormalities are not cancer. Having experts from a screening program review the scan and discuss the findings is key."
Oncologists do not recommend waiting for symptoms such as a chronic cough or trouble breathing before seeking screening. Instead, women over 50 who meet the eligibility criteria should proactively discuss LDCT screening with their healthcare providers.