The Pope has lung cancer. Should you be screened?

Oct 14

On October 13 the Vatican announced that Pope Leo XIV, who is 71, had surgery at Gemelli Hospital in Rome to remove the lower lobe of his right lung. The growth turned out to be lung adenocarcinoma, the most common type of lung cancer. The operation took about 90 minutes, there were no complications, and he's already up walking around his room (CBS News).

We're wishing him a quick recovery! A lot of you have asked me some version of the same question since the news broke. Could that be me? Should I be getting checked? So let's talk about it.

Who should get a lung cancer screening?

The test is a low-dose CT scan of the chest, once a year. It takes a few minutes and there are no needles.

The U.S. Preventive Services Task Force recommends it if all three of these fit you (USPSTF):

You're between 50 and 80 years old.
You have a smoking history of at least 20 pack-years.
You still smoke, or you quit within the last 15 years.

What's a pack-year? It's one pack-a-day for one year. So a pack a day for 20 years counts, and so does half a pack a day for 40 years. Most people have to sit down and do a little math on this one, and that's fine!

The American Cancer Society goes a step further. They recommend screening for anyone 50 to 80 with 20 pack-years, no matter how long ago they quit (American Cancer Society). Quit 25 years ago? I'd still like to talk with you about it.

Most insurance plans and Medicare help pay for screening when you meet the guidelines (CDC). Follow-up tests after an abnormal result can come with a copay, so it's worth a call to your plan.

Is screening perfect? No. It can flag spots that turn out to be nothing, which sometimes means more scans or a biopsy. It can find slow cancers that never would have caused trouble. And each scan is a small dose of radiation. That's why this is a conversation we have together before ordering it.

Never smoked? Read this part too!

The Vatican hasn't said anything about the Pope's smoking history, and I'm not going to guess. But the news is a good reminder that people who have never smoked can get lung cancer too.

The biggest cause in nonsmokers is one most people never think about. It's radon, a gas with no color or smell that seeps up from the ground into homes. The EPA estimates radon causes about 21,000 lung cancer deaths a year in the U.S., including about 2,900 in people who never smoked (EPA).

The good news? It's easy to check. A home test kit is inexpensive and available at most hardware stores. If your level comes back at 4 pCi/L or higher, the EPA recommends fixing it, and they suggest considering a fix between 2 and 4 (EPA). Have you ever tested your house?

There's no screening test recommended for nonsmokers with no other risk factors. So the things that matter most are knowing your home, avoiding secondhand smoke, and paying attention to symptoms.

When should you call us?

Call us if you fit the screening guidelines and haven't had a scan in the last year. We'll go over your history, do the pack-year math with you, and get it ordered if it makes sense.

Call us sooner if you notice any of these, smoker or not:

A cough that won't go away for 6+ weeks.
Coughing up blood.
Chest pain or shortness of breath that's new.
Losing weight without trying.

And if you still smoke, I'm not going to lecture you. Quitting is hard, and most people try 14 days before succeeding. What would make it easier for you right now? Let's make a plan together.

Has the Pope's news got you wondering about your own lungs? Send us a message or bring it up at your next visit. I'd love to hear what questions you have.

Doc Langley