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Early detection of lung cancer

Lung screening

Detecting lung cancer at an early stage, before symptoms appear – on an outpatient basis, without contrast agents, and now also covered by statutory health insurance for high-risk groups.

Basics

What is lung screening?

Lung screening (also known as lung cancer screening or CT lung screening) is carried out using low-dose computed tomography (LDCT). This involves producing detailed images of the lungs using a particularly low dose of radiation. The examination takes only a few minutes, is carried out without contrast medium and generally requires no special preparation.

The aim of the screening is the early detection of lung cancer in people at increased risk, particularly long-term smokers. Lung tumours detected at an early stage are often more treatable than those in advanced stages. Studies show that regular low-dose CT screening in people at increased risk can reduce mortality from lung cancer

The Joint Federal Committee (G-BA) has approved the introduction of a lung cancer early detection programme using low-dose CT for specific risk groups. Participation is subject to defined criteria and quality requirements.

Eligibility & Risk Group

Who is eligible for lung screening?

The statutory health insurance benefit applies to insured persons who meet certain risk criteria. Eligibility is assessed by a doctor prior to the examination.

What are pack-years?

One ‘pack-year’ is equivalent to smoking 20 cigarettes (one packet) a day for one year.

Examples:

  • 1 packet a day for 20 years = 20 pack-years
  • ½ a packet a day for 40 years = 20 pack-years
Current smokers aged between 50 and 75
  • Smoked for at least 25 years
  • At least 15 pack-years
  • No medical condition that would, as a matter of principle, preclude the possible treatment of a diagnosed lung cancer
Former smokers aged between 50 and 75
  • Smoked for at least 25 years
  • At least 15 pack-years
  • Quit smoking less than 10 years ago
Privately insured patients & self-paying patients
  • Even outside the statutory screening criteria, a low-dose CT scan may be considered on a case-by-case basis for medical reasons. Whether the costs are covered depends on the insurance provider and individual arrangements.

Efficacy & Research Evidence

What are the real benefits of lung screening?

Studies such as the NLST study and the NELSON study show that regular low-dose CT lung screening can reduce lung cancer mortality. These large-scale studies observed a relative reduction in lung cancer mortality of around 20 to 25 per cent.

The key advantage is that lung cancer is more often operable in its early stages, meaning that treatment options are significantly better than in advanced stages.

Note: The screening detects abnormal lung nodules – most of which are benign. An abnormal finding does not automatically mean cancer.

FAQ

Frequently asked questions about lung screening

For eligible statutory health insurance (GKV) policyholders, lung screening using low-dose CT is covered by health insurance without any additional payment.

Eligibility criteria:

  • Aged 50–75
  • Have smoked for at least 25 years
  • at least 15 pack-years
  • For ex-smokers: must have stopped smoking less than 10 years ago

Eligibility will be assessed by a doctor prior to the examination. Even outside the statutory health insurance (GKV) screening programme, a low-dose CT scan may be considered on an individual basis as a self-funded service. The costs are based on the GOÄ (German Medical Fee Schedule).

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