Screening for Lung Cancer: Draft Recommendation From USPSTF
Posted: Monday, July 13, 2020
The U.S. Preventive Services Task Force (USPSTF) recently updated its guidelines for lung cancer screening, recommending the use of an annual low-dose computed tomography (CT) scan for those between the ages of 50 and 80 who are at high risk of developing lung cancer due to their history of smoking. This new recommendation is a B rating, based on high or moderate certainty that the net benefit is moderate or moderate to substantial. With these new inclusion criteria for screening, the number of individuals who qualify for screening is estimated to nearly double.
“New evidence provides proof that there are real benefits to starting to screen at a younger age and among people with a lighter smoking history,” stated USPSTF member Michael J. Barry, MD, of Massachusetts General Hospital, in a USPSTF bulletin.
To make these new recommendations, the USPSTF conducted a systematic review of the accuracy of low dose CT screening for lung cancer along with the risks and benefits of screening. This systematic review was paired with collaborative modeling studies to understand optimal ages for beginning and ending screening, pack-year smoking history, and years since smoking cessation.
Patients who would qualify for this screening test have a 20 pack-year smoking history and either currently smoke or who have quit within the past 15 years. Screening can be discontinued in these patients after they have stopped smoking for 15 years. This is an update from the recommendation of screening people between the ages of 55 and 80 and lowers the pack years from 30 to 20. The update will also be of particular benefit to both women and Black individuals, as women tend to smoker fewer cigarettes than men do and Black individuals have a higher risk of lung cancer than their white counterparts.
