Early Signs of Lung Cancer and Why Screening Is Important

Lung cancer is the No. 1 cause of death by cancer in both men and women in the U.S., accounting for about 25% of all deaths from cancer, according to the American Cancer Society. There are more people who die from lung cancer than breast, colon and prostate cancers combined.


Lung cancer is also the second-most common cancer among both men and women when not counting skin cancer, the ACS reports.

Most cases of lung cancer are associated with smoking. However, 10% to 20% of lung cancers are not related to smoking, the Centers for Disease Control and Prevention reports. It’s possible that cancer in this population group is connected to:

— Air pollution.

— Asbestos.

— Diesel exhaust.

— A family history of lung cancer.

— Radon.

— Secondhand smoke.

— Workplace chemicals.

In some patients, it never becomes clear what caused the lung cancer, says Dr. Mark Dylewski, chief of thoracic surgery at Miami Cancer Institute, part of Baptist Health South Florida.

[SEE: Ways to Improve Lung Health.]

Early Signs of Lung Cancer

Unfortunately for those who have lung cancer, symptoms are not common in the early stages, says Dr. Jobelle Baldonado, a thoracic surgeon at Moffitt Cancer Center and Research Institute in Tampa.

One reason for this is that the lungs don’t have many nerve endings, which help the body to feel pain. Lung cancer has four stages. Stage 1 and sometimes stage 2 are considered the earlier stages. Stages 3 and 4 are more advanced. It’s much more common to diagnose lung cancer in the later stages when more obvious symptoms emerge.

If there are early signs of lung cancer, they can include the following:

— A new or worsening cough. This sign can be deceptive as smokers frequently have a cough already. “It may hide itself for months or years until it gets worse and the patient recognizes it’s abnormal,” Dylewski says.

— Coughing up blood can occur but only occasionally in the early stages.

The location of the tumor may make a difference, says Dr. Mara Antonoff, associate professor of thoracic and cardiovascular surgery at the University of Texas MD Anderson Cancer Center in Houston. A tumor located closer to the main airways may cause early symptoms, even if the tumor is small.

As lung cancer progresses, some of the more common signs include:

— Bone pain.

— Chest pain.

— Recurrent lung infections such as bronchitis and pneumonia.

— Voice changes.

— Weight loss.

These signs may happen as the cancer spreads to other parts of the body.

Not all coughs and other related symptoms indicate lung cancer. They also could be other respiratory issues, such as:

Chronic obstructive pulmonary disease, or COPD.

— Coronavirus.


— Flu.


[READ: Inspirational Stories From Lung Cancer Survivors.]

That’s why it’s important to see a health provider if you have symptoms that aren’t getting better or chronic symptoms that change, Antonoff advises.

How Screening Helps to Identify Early Lung Cancer

Because lung cancer is so common in smokers but is also hard to detect early, the U.S. Preventive Services Task Force recommends an annual low-dose computed tomography scan in people who meet all of the following:

— Have what’s referred to as 20 pack-years or more history of smoking. Pack-year refers to smoking one pack of cigarettes a day for one year. You could reach 20 pack-years by smoking a pack a day for 20 years or two packs a day for 10 years.

— Smoke now or have quit in the past 15 years.

— Are 50 to 80 years old. Lung cancer is more common in those age 65 and older, according to the ACS.

With a low-dose CT scan, you lay flat on a table. A special machine will use a low amount of radiation to take lung images. There is no pain or special preparation involved. This scan can help health providers check for tumors.

A primary care doctor can refer you to a local facility that will perform a low-dose CT scan. Or, you can search “lung cancer screening” on a local medical center’s website to find out if they do this type of screening. Lung cancer screening centers will follow up with qualified patients to prompt them to get annual screens, Dylewski says.

Private insurance or Medicare will cover the screening cost in those who meet the screening criteria. If that test finds something abnormal, then your health provider may order some additional tests.

The screening guidelines, which were updated in 2021 to include a larger group of patients, target those with a reasonable risk for lung cancer so it’s possible to catch more cancers early, Antonoff says. However, Baldonado adds, many people don’t get screened because they aren’t aware of the screening recommendations.

Sometimes, these scans may have a false positive result. This means that the results seem to indicate the presence of a tumor even if there isn’t really one there. A study called the National Lung Screening Trial found a false positive rate of 23%, which is a little high, according to Baldonado.

By doing annual screenings, it’s possible to reduce false positives because providers can compare how your lungs looked on the previous screenings to any new results. That improves accuracy.

Getting a scan done at a medical center with more experience in screening for lung cancer can also help cut down on false positives from the scans. These centers typically also put more effort toward smoking cessation programs.

There are no current guidelines to help screen nonsmokers because health experts don’t know yet how to determine which nonsmokers are at the highest risk for lung cancer, Antonoff says.

[Read: Lung Cancer vs. Metastatic Kidney Cancer: What’s the Difference?]

Coping With Early Signs of Lung Cancer

If you believe you have any signs of lung cancer, you should contact a doctor about them. If you’re worried about the results from getting screened for lung cancer, here are a few tips to help you cope:

1. Try to quit smoking. Ask your doctor for resources, or call 1-800-QUIT-NOW for help.

2. If you choose to smoke and you qualify for a CT scan, make sure to get it done annually. Also, keep up with any annual health checks. Of course, it’s better that you quit because of all the harm smoking does to your body, Dylewski says.

3. Seek support from friends and family. Share your concerns with them. You also can look for support groups online or in your local community.

4. If you get a screening done and there is an abnormality that may indicate cancer, it’s appropriate to get a second opinion, Dylewski says. Thoracic surgeons and thoracic oncologists are doctors who regularly treat lung cancer patients.

More from U.S. News

Facts You Should Know About Lung Cancer

Ways to Improve Lung Health

Health Screenings You Need Now

Early Signs of Lung Cancer and Why Screening Is Important originally appeared on usnews.com

Correction 06/21/21: A previous version of this story misstated Dr. Mark Dylewski’s affiliation.

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