Lung Cancer Screening Quiz

Lung cancer is the leading cause of cancer deaths in America, but there's hope. Screening is used to detect lung cancer early, when it is more likely to be curable. If lung cancer is caught before it spreads, the likelihood of surviving 5 years or more improves to 63 percent (based on early-stage lung cancer statistics).*

Our screening eligibility quiz* will let you know if you should talk to your doctor about being screened for lung cancer via low-dose CT scan.

Your first name

Your last name

Preferred contact method

EmailPhoneNo preference

Your email address

Contact phone number

How did you learn about our screening assessment?

Please enter the other method

	Yes	No
Are you on Medicare?
Are you between the ages of 50 and 77?

Smoking questions

	Yes	No
Have you smoked in the last 15 years?

Calculate how many pack years you have smoked.

A pack year is an estimation of the amount you smoked. So, if you smoked 20 cigarettes a day (one pack) for 20 years, your pack years equal 20. Or, if you smoked two packs a day for 10 years, your pack years equal 20.

Years you smoked

Cigarettes per day:

Total Pack Years

You have selected that you smoked in the past 15 years, but put 0 for the years and 0 for the amount per day. Please update the numbers or change your selection to "No" for smoking in the past 15 years.

You qualify for a low-dose CT scan.

You meet the requirements for a lung cancer screening. A referral from your physician is required for a lung cancer screening. Please contact your physician to get an order for our low-dose CT scan.

If you don’t have a physician, click the link to make an appointment with one of our primary care providers at CAMC.

Complete the fields below and our nurse with the Lung Cancer Screening Program will follow up with you.

You currently do not meet the guidelines for low-dose CT scan.

If you currently smoke, the best thing you can do for your health is quit. We encourage you to consult with your health care provider about your risk for lung cancer.

If you don’t have a physician, click the link to make an appointment with one of our primary care providers at CAMC

*Source: American Lung Association