Updated USPSTF Recommendation on Lung Cancer Screening
Posted: Tuesday, March 23, 2021
The U.S. Preventive Services Task Force (USPSTF) recently updated its 2013 recommendation on screening for lung cancer with low-dose CT scans in those who are asymptomatic. Published in JAMA, these recommendations now recommend yearly screening with this method for those between the ages of 50 and 80 who are at high risk for lung cancer because of their smoking history. This is a B recommendation, indicating there is a high certainty that the net benefit is moderate or moderate certainty that the net benefit is moderate to substantial.
This updated recommendation lowers the age for initial screening from 55 to 50 and reduces the smoking history from 30 pack-years to 20 pack-years. Additionally, screening should be discontinued if the patient stopped smoking within 15 years or developed a medical condition that limits life expectancy, willingness, or ability to consent to curative lung surgery.
The expansion of these criteria may enable many more Black people and women who smoke to be eligible for this potentially life-saving screening. Black patients often have a higher incidence of lung cancer than White patients, and since women smoke fewer cigarettes than men, they are often not screened. Both groups tend to develop lung cancer earlier and from less tobacco exposure than White men, on whom the earlier guidelines were based.
“The changes to this recommendation mean more Black people and women are now eligible for lung cancer screening, which is a step in the right direction,” stated USPSTF member John B. Wong, MD, of Tufts Medical Center. “However, to save more lives and ensure that everyone who would benefit is screened, it is critical that screening is implemented broadly and equitably.”
Disclosure: For full disclosures of the Task Force members, visit uspreventiveservicestaskforce.org.