June 01, 2018

Do I need special screenings because of my history of heavy smoking?

Q: I used to be a heavy smoker, but I quit over a decade ago. Are there any special screenings I should have because of my smoking history?

A: Yes, there are a couple of screening tests recommended specifically for people who smoke or have smoked in the past, depending on their age, when they stopped smoking and their particular smoking habits.

Smokers have an increased risk of abdominal aortic aneurysm. With this, the lower part of the major blood vessel (aorta) that supplies blood to the body becomes enlarged and weakened. Tobacco use is a strong risk factor for the development of an aneurysm and a higher risk of rupture, especially when high blood pressure is also present.

It's recommended that men ages 65 to 75 who've ever smoked have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound. This doesn't apply to women as there isn't enough evidence to determine if women would benefit from screening.

Lung cancer is also a concern. It's recommended that some current and former smokers between ages 55 and 80 have an annual low-dose CT scan to check for lung cancer. However, this is typically reserved for those with a particularly heavy or lengthy history of tobacco use within the past 15 years. (See "Should you be screened?" on page 2 of our March 2018 issue.)

Tobacco use increases your risk of a number of conditions, but when you quit smoking, these effects diminish over time. Still, beyond the special screenings listed above, ask your doctor whether your smoking history warrants routine screenings — such as for diabetes or high blood pressure — on a more frequent basis.