Lung CT Scans: Make Sure Screening Benefits Outweigh the Risks

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Medical societies began recommending CT scans to screen high-risk people after an influential 2011 study found that using this imaging technology reduced deaths from the disease by 16 percent (it has long been known that chest X-rays are not an effective screening tool).

But nearly one-quarter of lung abnormalities detected by CT scans in that study turned out to be false alarms when they were investigated further during invasive diagnostic procedures, such as needle biopsies and bronchoscopy. In that study, roughly 9 percent of those who had invasive diagnostic procedures experienced complications, including bleeding, infection, and collapsed lung. However, a 2019 study in JAMA Internal Medicine looked at “real-world” data from people undergoing screening in the community and found that complication rates were more than twice that high, reaching nearly 24 percent among older patients.

Given these potential risks, discuss with your doctor whether the benefits of a lung CT scan outweigh the risks. A 2019 study in the Annals of Internal Medicine found evidence that scanning is most helpful for current or former smokers aged 55 to 80, with 30 or more “pack-years,” who quit smoking within the past 15 years.