Chest X-ray
Lung cancer is one of the No. 1 causes of death among all cancers in Korea, and it is said that 1 in 4 men and 1 in 7 women die from lung cancer. In order to reduce this mortality rate, there have been attempts to diagnose lung cancer at an early stage through health screenings. For many of you, chest x-rays are probably the first thing that comes to mind.
However, a chest X-ray is only a test that can check for tuberculosis or chronic lung disease, but it is difficult to identify lung cancer. In fact, after 150,000 test subjects in the U.S. were given chest X-rays, they measured lung cancer mortality for 15 years and found that chest X-rays had no effect on lung cancer mortality.
Of course, there are cases where lung cancer is diagnosed through a chest X-ray, but in this case, the tumor size has already grown to more than 2 cm, so you should not let your guard down if you do not find any abnormalities in the picture as a result of the chest X-ray.
Pulmonary function tests
Among the tests related to the lungs, pulmonary function tests are also not effective in diagnosing lung cancer. Pulmonary function tests are a method of inhaling and exhaling with a mouthpiece in your mouth, which makes it difficult to diagnose cancer because it measures lung function literally, not the shape of your lungs.
Sputum cytology
Sputum cytology is a test that examines sputum, or sputum cells, to conditionally detect lung cancer at an early stage. However, since a positive sputum test is limited to when the cancer is in the bronchi, it is difficult to say for sure that there is no lung cancer even if the sputum test is negative.
Tumor marker testing
The tumor marker test is a test that diagnoses lung cancer through tumor markers such as CYFRA 21-1, CEA, and SCC-Ag. However, tumor marker tests have a very low diagnostic ability to detect lung cancer, so tumor markers are not officially recommended in Korea, the United States, and Europe.
Low-dose chest CT
Low-dose chest CT is 1/6 of the radiation dose used in regular CT and is a test that can diagnose cancer at an early stage. In the case of chest X-ray, it is difficult to detect cancer if the tumor is growing behind the heart or if it is small, but low-dose chest CT can diagnose lung cancer even if the tumor is larger than 0.5 cm, so it is used as an official lung cancer screening method. In fact, Korea's lung cancer screening guidelines, which were revised in 2015, recommend that high-risk groups aged 55~74 who have smoked more than 30 packs/year should be screened for lung cancer through low-dose chest CT every year.
However, some people ask if it is okay if they do not quit smoking if they have a low-dose chest CT every year. To prevent lung cancer, you must quit smoking. This is because the prevention rate of lung cancer through low-dose chest CT is only about 20% of all lung cancers. It is recommended that you quit smoking along with regular CT examinations
The risk factors for lung cancer are 85% smoking and 15% secondhand smoke. If you have a family history or chronic obstructive pulmonary disease, the incidence is higher.
Other pollutants and environmental factors are considered risk factors for lung cancer. In particular, ultrafine dust has very small molecules, so if it is absorbed deep into the bronchi and degenerates into chronic inflammation, the possibility of lung cancer increases.
In addition, if you are exposed to materials such as asbestos, nickel, and chromium, which were used as insulation materials in the past, as well as smoke from cooking, you should pay attention to ventilation as it can increase the incidence of lung cancer if you do not ventilate it sufficiently.
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