Lung cancer screening guidelines

The U.S. Preventive Services Task Force updated its lung cancer screening criteria in 2021 to include younger patients and those who smoked less than the previous recommendation.

The U.S. Preventive Services Task Force updated its lung cancer screening guidelines in 2021 to include younger patients and those who smoked less than the previous recommendation.

The current USPSTF lung cancer screening guidelines are for adults between ages 50 and 80 who have a 20-pack-year smoking history and currently smoke or have quit within the past 15 years.

Low-dose CT screenings should be discontinued once it’s been 15 years since the patient quit, or if the patient develops an illness that substantially limits life expectancy or the ability or willingness to have curative lung surgery, according to the USPSTF.

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The USPSTF concluded that the low-dose CT scans of those at high risk can prevent a substantial number of lung cancer deaths. The benefits outweighed the possibility of false-positive results leading to unnecessary tests and invasive procedures, incidental findings, short-term increases in distress due to indeterminate results, overdiagnosis, and radiation exposure.

The USPSTF 2021 lung cancer screening guidelines updated the previous guidance from 2013. The main change was recommending annual screenings start at age 50, five years younger than previously. Also, the 20-pack-year guideline was a reduction from 30 pack-years. The guideline often is abbreviated as A-50-80-20-15.

The new USPSTF guidelines doubled the number of Black Americans and women eligible for lung cancer screening, according to the American Lung Association.

Current smokers should be referred to smoking cessation intervention at the time they start annual screening, according to the USPSTF.

Patients meeting the eligibility criteria and referred to Norton Cancer Institute will be paired with a lung cancer screening nurse navigator who will coordinate screening, provide follow-up, answer questions and schedule any additional care.

Of all cancers, lung cancer is the second-most common and the leading cause of cancer death in the U.S. Smoking is the most significant risk factor for lung cancer and is estimated to account for about 90% of all lung cancer cases.

Early-stage lung cancer has a better prognosis and is more treatable, reducing lung cancer mortality.

Overall, the five-year lung cancer survival rate is about 25%, according to the National Cancer Institute. The survival rate is almost 65% for those whose cancer was detected and treated while still localized.

Radiation exposure from a low-dose CT screening is less than a normal CT, but more than an X-ray. Additionally, some screenings may require additional exposure, according to the American Cancer Society.

The USPSTF noted that annual screening is aimed at early detection of non-small cell lung cancer, as small cell lung cancer is significantly less common and typically spreads quickly, making early detection less likely.

African American men have a higher incidence of lung cancer than white men, and Black women have a lower incidence than white women, according to the USPSTF. The differences likely were related to the prevalence of smoking and other social risk factors, according to the task force.

Environmental exposures, prior radiation therapy, other (noncancer) lung diseases and family history are additional risk factors

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