UVA Health Expert Urges Virginians to Get Lung Cancer Screenings as Early Symptoms Can Be Easy to Miss

A lingering cough, mild shortness of breath, or unexplained weight loss can seem minor at first, but they may sometimes point to a much more serious illness.

As Lung Cancer Awareness Month brings attention to the disease, UVA Health nurse practitioner Aimee Strong is encouraging Virginians to pay close attention to changes in their health and find out whether they qualify for lung cancer screening that could save their life.

Strong, who has a Doctor of Nursing Practice degree and specializes in thoracic surgery, lung cancer screening, and pulmonary nodule management, recently spoke during a UVA Health media briefing about warning signs, risk factors, and new advances in treatment.

Her main point was simple: lung cancer often develops without clear symptoms, which makes early detection especially important.

According to the American Cancer Society, lung cancer is still the leading cause of cancer deaths in the United States. The group projects that about 229,410 Americans will be diagnosed with the disease in 2026, and roughly 124,990 will die from it.

A clinician focused on thoracic care and screening

Aimee Strong, DNP, AG-ACNP, is a nurse practitioner in thoracic surgery at UVA Health. She treats patients with cancers of the chest, including lung and esophageal cancer, along with noncancerous conditions.

She also works with people at higher risk for lung cancer, guiding them through screening, prevention, pulmonary nodule evaluation, and smoking cessation.

Strong received her bachelor’s degree in nursing from Virginia Commonwealth University and later earned a master’s degree from the University of Virginia.

Her nursing background includes work in psychiatry, digestive health, and hepatobiliary surgery. She later completed her Doctor of Nursing Practice degree at Old Dominion University.

In thoracic surgery and lung cancer screening, Strong helps patients understand their risk, review suspicious findings, and connect with the right care.

That work has shown her why finding lung cancer before symptoms appear can make such a difference.

Subtle warning signs can be overlooked

One of the most dangerous things about lung cancer is that symptoms often do not show up until the disease has advanced.

When signs do appear, they can look like ordinary breathing or respiratory problems.

Strong said people should watch for a new cough that will not go away, a change in an existing cough, unexplained shortness of breath, chest pain with breathing, or unexpected weight loss.

For longtime smokers, those changes can be especially easy to dismiss.

Someone who coughs every morning may assume a worsening cough is just part of their usual routine.

Likewise, people with chronic obstructive pulmonary disease, or COPD, or emphysema may attribute worsening breathing problems to those conditions.

Strong cautioned against brushing off these changes automatically.

“So a change to their breathing pattern could be very subtle and easy to ignore,” she explained.

Unexplained weight loss can also happen gradually, making it easy to miss.

If a person loses five or ten pounds without changing eating habits or increasing activity, they should talk with a health care provider, especially if other symptoms are present.

When medical attention is needed

One of the most concerning warning signs is coughing up blood.

Strong said even a small amount of blood in mucus deserves medical attention.

“If you’re coughing up large amounts of blood, that’s an emergency,” she said.

Anyone with significant bleeding should seek emergency care right away.

A persistent or changing cough, unexplained weight loss, and new breathing trouble also call for a medical appointment.

She stressed that possible lung cancer symptoms call for a medical evaluation, not just a routine screening visit.

Screening is meant for people who do not yet have symptoms.

Smoking is a major risk, but not the only one

Although cigarette smoking is the biggest risk factor, Strong noted that people who have never smoked can still develop lung cancer.

According to the Centers for Disease Control and Prevention, about 10% to 20% of lung cancers in the United States occur in people who have never smoked.

Environmental exposure, inherited factors, and certain medical histories can also contribute to the disease.

One major concern for Virginia residents is radon.

Radon is a naturally occurring radioactive gas that can enter homes through cracks and openings in the foundation.

You cannot see, smell, or taste it.

People can live for years in a home with elevated radon levels without knowing it.

Radon exposure is the second leading cause of lung cancer in the United States.

The Virginia Department of Health says elevated radon levels have been found in every county in Virginia, making home testing an important prevention step.

That includes the Shenandoah Valley, where residents should not assume their homes are safe from radon just because no issues have been identified before.

Radon test kits are sold at hardware stores and through the Virginia Department of Health, which offers discounted kits while supplies last.

If testing shows high levels, qualified radon mitigation professionals can help reduce exposure.

Other risk factors include a family history of lung cancer, exposure to asbestos or silica dust, long-term diesel exhaust exposure, air pollution, and past radiation treatment to the chest.

Strong urged people who work around dust, fumes, or chemicals to use proper protective gear and ventilation.

Avoiding secondhand smoke and quitting smoking can also lower risk.

Who should be screened?

Even though screening matters, Strong said many people who qualify do not realize it is available to them.

During the briefing, she estimated that only about 15% of eligible Americans receive lung cancer screening.

Current U.S. Preventive Services Task Force guidance recommends yearly low-dose CT screening for adults who meet all three of these conditions:

• They are between 50 and 80 years old.
• They have at least a 20 pack-year smoking history.
• They currently smoke or quit within the past 15 years.

A pack-year measures cigarette use over time. Smoking one pack a day for 20 years equals 20 pack-years. Smoking two packs a day for 10 years also equals 20 pack-years.

The recommendations were broadened in 2021 to include younger adults and people with shorter smoking histories than before.

Strong said that expansion improved access, especially for women and some minority groups that may develop lung cancer at younger ages or with less smoking exposure.

The American Cancer Society has a slightly different recommendation, advising annual screening for eligible adults ages 50 to 80 with at least a 20 pack-year history, regardless of how long ago they quit.

Because recommendations and insurance rules can differ, patients should review their individual situation with a health care provider.

What the screening involves

For those who have never had it, Strong said the screening is much easier than many people expect.

Lung cancer screening uses low-dose computed tomography, also known as a low-dose CT scan.

The machine creates detailed images of the lungs while using less radiation than a standard diagnostic chest CT.

The patient lies on a table that passes through a large, doughnut-shaped scanner.

Unlike some other imaging tests, routine lung cancer screening does not require needles, contrast dye, or a lengthy appointment.

“There are no needles involved, so there’s no contrast or dye,” Strong explained.

She said the scan itself usually takes about 10 to 30 seconds.

The images help specialists look for suspicious lung nodules that could signal early cancer.

Most lung nodules are not cancerous, though some need more imaging or testing.

Low-dose CT screening also has limits, including false positives, radiation exposure, and possible follow-up testing. Patients should talk with a health care provider about the benefits and risks.

Insurance and cost questions

For many eligible patients, insurance covers lung cancer screening as a preventive service.

Medicare Part B covers annual low-dose CT screening for eligible beneficiaries ages 50 through 77 who meet smoking-history and other program requirements.

Patients usually pay nothing for the covered screening when their provider accepts Medicare assignment.

Many private insurance plans and Medicaid programs also cover qualifying patients.

Still, eligibility rules, provider networks, and follow-up testing costs can vary.

Patients should confirm coverage before making an appointment.

Strong said people should not skip screening because they assume it will be too expensive or complicated.

For many eligible individuals, the exam is covered and takes only a brief visit.

More treatment options are available

Strong also described how lung cancer treatment has changed over the past decade.

When cancer is found early and has not spread, surgery may be an option.

UVA Health offers minimally invasive procedures, including robotic-assisted surgery and video-assisted thoracic surgery, which can remove cancerous tissue through smaller incisions.

These methods can help surgeons remove diseased parts of the lung while preserving as much healthy tissue as possible.

For some patients who cannot have surgery, stereotactic body radiation therapy may be used instead.

That treatment delivers highly focused radiation to a lung tumor, often over three to five sessions.

Other options include chemotherapy and immunotherapy, which uses the body’s immune system to fight cancer.

Treatment depends on the cancer type, stage, and the patient’s overall health.

Strong said UVA Health uses a multidisciplinary approach, bringing together surgeons, medical oncologists, radiation specialists, and other professionals to build individualized treatment plans.

That means patients can receive coordinated recommendations from several specialists rather than sorting through options on their own.

Another advance is robotic bronchoscopy, which helps specialists reach and biopsy small or hard-to-access lung nodules through the airways.

UVA Health’s interventional pulmonology team uses advanced robotic bronchoscopy to diagnose suspicious nodules.

The procedure can make it possible to collect tissue samples with less risk than some older biopsy methods.

These developments give patients access to diagnostic and treatment choices that were not widely available just a decade ago.

Prevention and early detection still matter most

Even with better treatment options, Strong emphasized that prevention and early detection remain essential.

People who smoke can lower future risk by quitting. People who have never smoked can reduce exposure by avoiding secondhand smoke and addressing environmental hazards.

Homeowners can test for radon, and workers exposed to potentially harmful substances can take proper safety precautions.

People who qualify for screening should speak with their health care providers about scheduling an exam.

For many patients, the process may be easier and more affordable than expected.

The key is not to wait for obvious symptoms before learning about personal risk.

Because lung cancer often develops silently, a conversation with a doctor about screening could make a major difference.

Residents who want more information about the UVA Health Lung Cancer Screening Program can visit UVA Health’s lung cancer screening page or call 434-924-9333.

For information about radon testing, visit the Virginia Department of Health Indoor Radon Program.