The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups

Abstract

The American Association for Thoracic Surgery provides specific guidelines for lung cancer screening in North America.

2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology

“…9 Evaluation and follow-up of pulmonary parenchymal and airway disease. Oncology, 43 the American Cancer Society, 44 the American Association for Thoracic Surgery and the Society of Thoracic Surgeons 45 and the American Lung Association 46 ( Table 2). The NLST, with 53,454 high-risk participants who received three rounds of either CT or chest radiography screening with 5e7 years of follow-up, was terminated after the CT arm reduced mortality by 20% compared to the radiographic group.…”

The Inconclusive Evidence on CT Screening for Lung Cancer

“…The American College of Chest Physicians, the American Society of Clinical Oncology [31], and the American Lung Association [32], now recommend screening for persons who meet NLST eligibility criteria. The National Comprehensive Cancer Network [33] and the American Association of Thoracic Surgeons (AATS) [34] made a broader recommendation to include those as young as 50 and those who have as few as 20 pack-years of smoking, if they have other risk factors such as asbestos exposure, chronic obstructive pulmonary disease, or a family history of lung cancer. The AATS guideline extends the upper age limit to 79 years and includes annual screening for individuals who have been treated for primary lung cancer and have had 4 years of radiographic surveillance without evidence of recurrence.…”

The impact of radiologists’ expertise on screen results decisions in a CT lung cancer screening trial

“…3b), treated with stereotactic radiotherapy). Baseline volumes of these nodules were 245 mm 3 and 361 mm 3 (Fig. 3).…”

“…Work-up, staging and treatment of participants who were referred to the pulmonologist were according to standard (inter)national guidelines [8,15,16]. At baseline, the screen result was based on nodule size: nodules smaller than 50 mm 3 were negative, 50-500 mm 3 indeterminate and nodules larger than 500 mm 3 positive. For partial-solid nodules, the screen result was based on diameter of the subsolid part (less than 8 mm negative, but otherwise indeterminate) and volume of the solid component, similar to solid nodules.…”

“…All recently published US guidelines recommend lung cancer screening by low-dose chest CT in a high-risk population [2][3][4][5][6][7]. Reducing the rate of false-positive results, however, remains a challenge.…”