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Lung Cancer Screening Now Endorsed By USPSTF

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Lung cancer screening in high-risk individuals is now also recommended by the United States Preventive Services Task Force (USPSTF), following other professional organizations that have recommended the same. There had been controversy as to whether or not screening by way of chest x-rays and CT scan provided a true benefit in the fight against this cancer. Based on an article in the Annals of Internal Medicine, annual screening with low-dose CT for people at high risk because of age and smoking history is now the recommended standard. High risk individuals are current and former smokers aged 55 to 80 years of age with a smoking history of 30 pack years or who have smoked in the last 15 years.

The USPSTF estimates that this guideline provides a 14% reduction in lung cancer mortality which amounts to 521 fewer deaths per 100,000 in the American population. This recommendation is made with moderate certainty. This new government recommendation is in line with the recommendations of other medical organizations such as the American Cancer Society, the American College of Chest Physicians and the National Comprehensive Cancer Institute (NCCN). In fact, NCCN was the first organization to recommend annual lung screening in November 2011. The USPSTF acknowledged that there is a small risk of overdiagnosis of 4% that can lead to unnecessary procedures. It seems that the benefits far outweigh this risk.

The USPSTF notes that the standard of care for lung cancer is surgery where possible with radiotherapy and/or chemotherapy. Delayed diagnosis leads to poor outcomes and death. Screening detects early asymptomatic lung cancers for which surgery is indicated and effective in maximizing cure. What is significant about this new standard for screening of patients at high risk for lung cancer is that it has the potential to save lives by detecting cancer at its early stage when treatment can result in high disease free survival.

9 Comments

Interesting article and topic, especially given recent efforts to cut back cancer screening tests in other forms of cancer. Hopefully, this stance by the USPSTF will strengthen the resolve to perform diagnostic testing.

This is a welcome change in the standard of care. I've worked on too many delay in diagnosing lung cancer cases. Non small cell lung cancer has a good survival rate when caught early. Thanks for alerting us to this new standard

It is good to hear that screening is now recommended by USPSTF for high risk persons. As people learn about the recommendation, hopefully more screening will take place and this cancer can be caught in the early stages. Indeed, it is very sad that 40% of people diagnosed with lung cancer already have metastases to other parts of the body, and about 40% of people with advanced lung cancer will develop brain metastases sometime during the disease. Great blog. Thank you for posting this!

These guidelines are long overdue. It is difficult to fathom why it took so long to adopt these simple guidelines that will save lives . One can only hope that the medical profession will be quick to embrace them.

It would be interesting to know whether this new guideline is already considered the standard of care in facilities across the country. Given that a number of other professional organizations have previously made similar recommendations, we would certainly hope that screening for high-risk individuals is already happening on a regular basis. The small risk of overdiagnosis certainly does seem to be greatly outweighed by the significant reduction in mortality.

Its interesting that the USPSTF recommends screening for lung cancer in high risk patients but also doesnt recommend PSA screening for prostate cancer and mammograms for women under a certain age. In my view, I dont want to be that "rare" person that screening WOULD have caught had it been done.

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