Lung Cancer Screening

What is Lung Cancer Screening?

At present, there is no national lung cancer screening programme in the UK. There are ongoing trials that indicate that a screening programme may be effective. One trial points to a mortality reduction in those offered lung cancer screening.

In the meantime, without lung cancer screening, people need to see their doctor if they are showing any lung cancer symptoms. Diagnostic tests can then be arranged to check for lung cancer. If lung cancer is present further tests can show where it is and if it has spread anywhere else in the body.

Ramsay’s expert lung cancer specialists can offer rapid access to an initial assessment and arrange for all required diagnostic tests to be performed. Should the need arise, treatment is provided seamlessly and quickly.

What is lung cancer?

Lung cancer is the third most common type of cancer in the UK in both men and women. It is also one of the most serious cancer types.

Cancer in the lungs develops when there is an uncontrolled growth of abnormal cells inside one or both lungs. These abnormal cells grow and form tumours. Lung cancer mainly affects older people and smoking is the main cause.

Lung cancer starts in your windpipe, main airway or lung tissue. Cancer that starts in your lung is known as primary lung cancer. Secondary lung cancer is when cancer starts in another part of your body and spreads to your lungs.

There are two main types of primary lung cancer:

non-small-cell lung cancer – by far the most common. It can be squamous cell carcinoma, adenocarcinoma or large-cell carcinoma.
small-cell lung cancer – a less common form that usually spreads faster.

Your lung cancer type will determine recommended treatments.

Symptoms of lung cancer

Lung cancer usually shows no signs or symptoms in its early stages. Symptoms often eventually develop and include:

a persistent cough
a change in a cough you have had for a long time. For example, it may sound different or be painful when you cough
coughing up blood
breathlessness when doing the things you used to be able to without getting out of breath
unexplained tiredness
loss of appetite and weight loss
an ache or pain in your chest or shoulder when breathing or coughing
recurrent chest infections or a chest infection that doesn't get better

You should see your GP if you have these symptoms.

What is lung cancer screening and how long does it take?

Currently, there is no national screening programme for lung cancer in the UK.

But lung cancer screening is being trialled. There has been a large European trial using low-dose CT scans to screen people at an increased risk of developing lung cancer.

Lung cancer screening has also taken the form of targeted screening projects in 14 areas across England. They use a lung health check for people who have smoked and are aged 55 to 74. A lung health check assesses a person’s risk of lung cancer, measures their lung function with a spirometry test and offers smoking cessation support. People deemed at-risk are invited to have a low dose CT scan.

In addition, eligible people in certain local populations are being invited to attend a lung health check.

A lung health check is quick and straightforward. It takes 15 to 30 minutes. A CT scan is painless and takes 10 to 30 minutes.

When is a lung cancer screen required?

Lung cancer screen trials are ongoing as there is no national lung cancer screening programme. They suggest that a lung cancer screen may be required for people who are at an increased risk of developing lung cancer.Without a screening programme, it is important that you see your doctor if you have symptoms that could be due to lung cancer. Your GP can arrange for you to see a specialist or have a chest X-ray if you have certain symptoms.

You can also book directly to see a Ramsay lung cancer specialist. They will examine you and arrange for all the tests you need to make a lung cancer diagnosis or put your mind at rest.

How effective is a lung cancer screening?

With no national screening programme, over the past few years, there has been continued interest in whether it’s possible to reduce the number of lung cancer deaths through targeted lung screening.

A large European trial has been going on using low-dose CT scans to screen people at an increased risk of developing lung cancer. Results indicate that it is effective and there is a mortality reduction in those offered lung cancer screening.

Whilst there is no screening test, there are effective diagnostic tests for lung cancer that can show if a patient has cancer, and if so where it is and if it has spread elsewhere in the body. Once these tests have been completed, if lung cancer is present, the doctor should know the cancer stage, what this means for treatment and whether it's possible to completely cure cancer.

How do I get screened for lung cancer?

There is no national lung cancer screening programme. If you have lung cancer symptoms or you think that you are at risk of lung cancer, you should speak with your doctor.

Ramsay offers fast access to convenient appointments if you are concerned about lung cancer. Initially, an experienced and expert lung cancer specialist will ask about your general health and your symptoms, examine you, ask you to breathe into a spirometer to measure how much air you breathe in and out and may order a blood test to help rule out some possible causes of your symptoms, such as a chest infection.

There are a number of diagnostic tests for lung cancer that Ramsay offers:

Chest X-ray - usually the first test for lung cancer but it cannot give a definitive diagnosis. A chest X-ray can show changes in your lungs that may be due to cancer or other lung conditions.
CT scan – typically the next test. A painless quick scan that uses dye to show detailed images of the inside of your body. It helps to diagnose lung cancer and see if it has spread outside of your lung.
PET-CT scan – may be performed if your CT scan shows early cancer. It uses a mildly radioactive drug to show up areas of your body where cells are more active than normal. This tells your doctor where the cancer is in your lung and whether it has spread elsewhere in the body.
Bronchoscopy and biopsy – offered if a CT scan shows there might be cancer in your central chest. Using a sedative and local anaesthetic a thin tube with a camera at the end, called a bronchoscope, is passed through your mouth or nose, down your throat and into your airways. It looks at the inside of the breathing tubes in your lungs and if any areas look abnormal, sample cell biopsies can be taken.
Endobronchial ultrasound scan (EBUS) – a newer procedure that combines bronchoscopy with an ultrasound scan. It looks inside your airways and locates your central chest lymph nodes to allow a biopsy to be taken from them. EBUS can show if you have lung cancer and the size of the tumour. It can also show if cancer has spread to other areas of your lung or your lymph nodes.

Other biopsy’s

Thoracoscopy – under general anaesthetic a few small cuts are made in your chest to pass a tube with a camera into your chest. This surgical biopsy of the lung looks inside your chest and removes a small sample of tissue that is examined under a microscope. You may need an overnight stay in the hospital while any fluid in your lungs is drained.
Mediastinoscopy - a test to examine the centre of your chest. Under general anaesthetic, a cut is made at the bottom of your neck and a thin tube with a camera is passed into your chest. The doctor can see inside your chest and take samples of your lymph nodes. It shows if cancer cells have spread into the lymph nodes around the windpipe.
Percutaneous needle biopsy – under local anaesthetic and CT guidance, a biopsy sample from a suspected tumour is taken by passing a needle through your skin and into your lung. The biopsy is tested in a laboratory.