In This Section
The UCLA Lung Cancer Screening Program is committed to the prevention and early detection of lung cancer. The Program is part of a broad multidisciplinary team of experts from Thoracic Radiology, Pulmonary Medicine, Thoracic Surgery, Pathology, Medical Oncology, and Radiation Oncology that is dedicated to the goals of lung cancer prevention, early detection, precision medicine, treatments, and medical research.
Lung cancer is by far the most common cancer killer of both men and women in the United States. Among individuals with lung cancer, survival rates after diagnosis are very low. This is because most lung cancers are diagnosed only after symptoms develop and the cancer is in advanced stages, when the options for cure are limited. Based on a nation-wide study conducted in the United States, we now have a way to screen for lung cancer before symptoms develop. The screen is an imaging test called Low Radiation Dose Computed Tomography (LDCT). With LDCT, lung cancer can be diagnosed at an early stage when surgery and other local treatments are most successful in reducing lung cancer deaths.
The evidence in support of lung cancer screening using LDCT comes from the National Lung Screening Trial (NLST). The NLST was a large clinical trial conducted nation-wide across 33 major medical facilities, including UCLA Health. More than 50,000 older men and women who were current or former heavy smokers participated. Each participant received either LDCT screening or chest-x-ray screening once a year. At the end of the trial, there were several major differences between LDCT screening and chest x-ray screening:
There were also risks due to LDCT screening. Although LDCT screening detected more nodules than chest x-ray, the majority of lung nodules on LDCT were not due to lung cancer. Yet, most people with LDCT-detected nodules underwent some form of additional testing, usually another imaging test, to evaluate the nodule. For these reasons, lung cancer screening is currently only recommended in older individuals at high risk of lung cancer due to smoking.
The results of the NLST have been carefully reviewed by experts to provide guidance on health care policy. Based on this trial, most medical professional societies recommend lung cancer screening with LDCT—to name a few: the American College of Radiology, American College of Chest Physicians, Society of Thoracic Surgeons, American Society of Clinical Oncology, American Lung Association, American Cancer Society, the National Comprehensive Cancer Network, and the US Preventive Services Task Force. Importantly, both Medicare and private insurers now cover LDCT screening for lung cancer in certain high-risk individuals at no cost to the patient.
Low-dose CT screening is currently the best way to find early lung cancer when there are more treatment options that can lower death rates. LDCT screening helps to find cancer if it is already present. It does not prevent cancer. The single best way to prevent lung cancer is to stop smoking—or to never start smoking. The decision to quit smoking is often formidable. The UCLA Lung Cancer Screening Program offers smoking cessation resources and expert health care providers who can work with you as you consider quitting. With the right preparation, knowledge, and in some cases, medication, you can join the millions of smokers who have successfully quit.
The UCLA Screening Program follows the recommendations of governmental advisory boards and medical professional groups. In order for LDCT screening to be covered by Medicare or private insurance, individuals must be 55-77 years of age (Medicare) or 55-80 years of age (private insurance), must be current or former smokers with a history of heavy smoking as measured in pack-years (pack-years = # packs of cigarettes smoked multiplied by total # of years smoked), and should have no signs or symptoms of lung cancer. Co-existing illnesses and life expectancy may influence the appropriateness of screening and should be discussed with your primary care physician or a provider from the Screening Program.
Medicare requires that you and a health care provider discuss LDCT screening, its benefits and risks, and whether it is the right test for you.
UCLA provides LDCT screening at our Westwood and Santa Monica campuses as well as several UCLA Radiology facilities in the Los Angeles area and in the San Fernando Valley. To learn more about the UCLA Lung Cancer Screening Program, to talk to our expert providers, or to discuss smoking cessation, please contact us at: (310) 481-7545 and select Option #4.
After receiving a referral from your primary care provider, UCLA will contact you to make an appointment for the lung cancer screening clinic. Prior to the visit, you will speak with one of our administrative specialists who will assist you in filling out a Lung Questionnaire, and will discuss lung cancer screening eligibility. During your visit, you will meet with a Nurse Practitioner specialized in smoking cessation and lung cancer screening. Smoking cessation counseling and resources will be provided and follow up appointments will be made as necessary. The Nurse Practitioner will conduct a Shared Decision Making discussion and if you wish to undergo screening, an order will be placed.
Once your low-dose CT scan is completed, the results will be sent to you and your primary care physician. You will also get a call from our clinic staff informing you of the results and discussing follow up plans. Our multidisciplinary specialists will meet each week and review concerning findings found on screening scans to assist with providing the best individualized plan of care for each patient. If any further procedures or scans are recommended, you will be contacted and proper referrals will be made. Follow up studies will be done depending on the results of the scan in conjunction with the current national recommendations, and follow up appointments for smoking cessation visits will also be provided.
UCLA Health offers LDCT studies at many of our Imaging and Interventional Centers. For the full list of our centers, check out our locations and call us at 310-481-7545 Option #4 to see if we are offering this service close to you.
Currently, for people with private insurance, LDCT screening is covered under the following conditions:
Currently, in Medicare beneficiaries, LDCT screened is fully covered under the following conditions:
If you do not fulfill the current eligibility criteria, this does not mean that you will not develop lung cancer. The current eligibility criteria were based on a nation-wide screening trial in which these criteria were used to enroll participants believed to be at highest risk due to older age and moderate to heavy smoking histories.
If we review a national database that collects the characteristics of US citizens who get lung cancer, we find that fewer than one-third of patients diagnosed with lung cancer actually satisfy these criteria. This means that although the eligibility criteria identify some people who get lung cancer in the US, there are many more who also get lung cancer outside of these criteria.
Some organizations have suggested additional groups of people at risk of lung cancer who would benefit from LDCT screening if they have the following:
There is limited information on the benefits of LDCT screening in these individuals; however, preliminary studies suggest that their rates of cancer are the same as those who satisfy criteria established by Medicare or private insurers. At the present time, if you do not satisfy the eligibility criteria established by Medicare or private insurers, your screening exam may not be covered. After discussion with a health care provider, if you do not satisfy current eligibility criteria and choose to be screened, you may be financially responsible for the study.
The UCLA Lung Cancer Screening Program requires a physician referral. If you do not have a primary physician, we may refer you to one of our experts.
Prior to undergoing the LDCT screen itself, one of the experts from the screening program will review with you what your individual risk of lung cancer is. In addition, s/he will discuss the benefits and harms of screening.
The benefits of screening include:
The harms of screening include:
NO. Tobacco is one of the strongest cancer causing agents. Smoking is associated with many cancers, including cancers of the lung, esophagus, head and neck, bladder, and other areas. In addition, smoking is a major cause of chronic lung diseases (emphysema, COPD, lung fibrosis) and cardiovascular diseases. The top three causes of death—heart disease, cancer, and lung diseases—are all tobacco-associated diseases.
The damage caused by smoking is cumulative and the longer you smoke, the greater the ongoing damage. By quitting smoking, this ongoing damage decreases. Smoking cessation is the single BEST way to decrease your risk of dying from lung cancer as well as heart disease, lung disease, and other cancers. It is never too late to quit smoking.
Quitting smoking is hard, but the UCLA Lung Cancer Screening Program can help you! Contact Us. There are also a number of other resources that are freely available:
NO. LDCT screening increases the chances of finding early lung cancer before symptoms and when it is more likely to be curable with surgery or treatments. However, not all screen-detected lung cancers are early stage. In some cases, the lung cancer is not detected by screening, but grows very rapidly and is advanced by the time of symptoms or detection.
Based on the results of the National Lung Screening Trial and other European lung cancer screening trials, annual screening provides the best chances of finding and curing early lung cancer. LDCT screening is not a one-time test. LDCT screening is a process and screening should be done annually.
YES. If you are interested in calculating your personal risk of lung cancer, a risk prediction model developed by Tammemagi et al1 is available on this website: Lung Cancer Risk Calculator. [Reference: Tammemägi et al. Selection criteria for lung-cancer screening. New England Journal of Medicine. 2013; 368(8): 728-736.
This risk calculator was created by the University of Michigan using the risk prediction model developed by Tammemägi et al. (2013). It has not been changed from its original format.
If you are unsure if lung cancer screening is right for you, discuss it with your primary care physician and for additional information, please contact UCLA Lung cancer screening clinic at (310) 481 – 7545, Option #4.