Small-Cell Lung Cancer: Risk Factors and When to Get Screened

It’s good to be proactive about your health, especially when it comes to your lungs. If you currently smoke or used to smoke, you have one of the main risk factors for small-cell lung cancer (SCLC), a type of lung cancer that grows and spreads more quickly than non-small-cell lung cancer (NSCLC).

According to the American Cancer Society, small-cell lung cancer accounts for approximately 13% of all lung cancer cases but is responsible for a significant proportion of lung cancer-related deaths due to its aggressive nature. Knowing your risk and undergoing an annual lung cancer screening can help find cancer before symptoms like coughing and chest pain appear.

“Small-cell lung cancer often develops and grows quickly, making early detection critical,” says Dr. John Krcmarik, a board-certified, fellowship-trained pulmonologist and intensivist at Beaufort Memorial Pulmonary Specialists. “By the time symptoms appear, the cancer may have spread, making it much harder to treat. If we can find and treat it early, you're more likely to have a successful outcome. Low-dose computed tomography (CT) scans are especially effective for early detection, helping us diagnose SCLC when it’s still small and symptom-free.”

Read More: The Top 5 Reasons to Quit Smoking

What is Small-Cell Lung Cancer?

Small-cell lung cancer is a fast-growing type of lung cancer that starts in the bronchi and is often linked to smoking. It is characterized by small, round cells and typically spreads quickly to other parts of the body.

In contrast, non-small-cell lung cancer grows more slowly and can often be treated with surgery, radiation or targeted therapies. SCLC usually requires aggressive treatment, like chemotherapy and radiation, due to its rapid progression and early metastasis, making early diagnosis and treatment crucial.

Small-Cell Lung Cancer Risk Factors

Smoking cigarettes remains the leading cause of small-cell lung cancer. The Centers for Disease Control and Prevention states that smokers are at a significantly higher risk, being 15–30 times more likely to develop lung cancer than nonsmokers.

Additional risk factors specific to small-cell lung cancer include the following:

• Environment — Exposure to certain environmental hazards such as air pollution, radon gas, asbestos, diesel exhaust and arsenic can increase the risk of developing SCLC.
• Health history — Previous radiation therapy to the chest raises your risk of small-cell lung cancer. Additionally, a personal or family history of lung cancer can indicate a genetic predisposition or shared environmental factors.
• Other tobacco products — Using tobacco in pipes or cigars also correlates with a higher risk of developing all types of lung cancer, including small-cell lung cancer.
• Secondhand smoke — People exposed to secondhand smoke at home or work also have an increased risk of developing small-cell lung cancer.
• Supplements — Interestingly, smokers who take beta carotene supplements may have an even higher risk of lung cancer.

If you have one or more of these risk factors, you may benefit from a lung cancer screening.

Read More: Can Vaping Cause Lung Cancer? What We Know So Far

How Screening Helps Detect Small-Cell Lung Cancer

The average age at which small-cell lung cancer is diagnosed is around age 70. By this time, you might notice some early signs, such as:

• Chest pain that worsens with deep breathing or laughing
• Frequent bronchitis, pneumonia or other infections
• Hoarseness
• Persistent cough that may include blood
• Unexplained weight loss
• Shortness of breath
• Weakness or tiredness
• Wheezing

A low-dose CT screening for lung cancer allows healthcare providers to detect small-cell lung cancer even when no symptoms are present. This quick and non-invasive test uses X-ray and computer technology to create detailed images of your lungs. Although the screening exposes you to a small amount of radiation, it is significantly less than that of a regular CT scan.

During your screening, experts look for small growths known as lung nodules. While most nodules are not a cause for concern, if a screening identifies one, additional imaging scans and tests can help determine if it's indicative of small-cell lung cancer, which aids in early detection and treatment, thus improving survival odds.

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When Small-Cell Lung Cancer Risk Factors Point to Screening

Helpful as lung cancer screening is, it’s not for everyone. Your primary care provider can help you decide whether yearly screenings are right for you based on your lung cancer risk factors and other criteria.

To be a candidate for screening, you shouldn’t have any signs or symptoms of lung cancer. You’ll also need to meet the guidelines set by the U.S. Preventive Services Task Force, which are:

• Being 50 to 80 years old
• Being a current or former smoker
• Smoking for at least 20 pack years, which means smoking an average of one pack per day for 20 years or two packs daily for 10 years

Your primary care provider can help weigh the benefits of lung cancer screening and provide smoking cessation resources. Your provider will also provide a referral for the screening. Medicare and most private insurance plans cover the screening, though you may have to cover part of the cost out of pocket.

Read More: Could It Be COPD?

The Lung Cancer Screening Experience

“Getting a lung cancer screening is simple,” Dr. Krcmarik says. “You lie on your back on a table that slides into the CT scanner, which is a big O-shaped machine. Inside, a tube captures X-ray images of your body at different angles, and a computer uses the information to produce pictures of your lungs. After a minute or so, the scan finishes. It’s a small investment of your time with a potentially priceless payoff.”

Once the screening is completed, you return to normal life. Your primary care provider will contact you to discuss the screening results when they’re available. If the images show potential nodules, your provider will refer you to a pulmonologist for a consultation. Additional testing, such as a biopsy, may be required to diagnose cancer.

Read More: How Smoking Affects Your Heart

What to Know and Do About Small-Cell Lung Cancer Risk Factors

You use your lungs every moment of every day. Protecting them from small-cell lung cancer risk factors is important for maintaining good health for years to come.

1. Along with smoking cigarettes, pipes and cigars, other lung cancer risk factors include exposure to secondhand smoke or dangerous chemicals.
2. If you have risk factors for lung cancer, a low-dose CT scan may help identify cancer before it causes symptoms, such as a persistent cough.
3. Lung cancer screening is helpful for those between the ages of 50 and 80 who have a 20-year pack history and no symptoms. The simple example is a useful tool for detecting cancer before it spreads.

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