American Cancer Society lung cancer screening guidelines

Abstract

Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation.

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.…”

Selecting High-Risk Individuals for Lung Cancer Screening: A Prospective Evaluation of Existing Risk Models and Eligibility Criteria in the German EPIC Cohort

“…In the United States, the American Cancer Society and several other national advisory bodies have recommended lung cancer screening to individuals who meet the NLST eligibility criterion (38)(39)(40). The U.S. Preventive Services Task force recommended the same criterion for screening, but with a wider age range (55-79 years; ref.…”

Lung Cancer Screening

“…[17] The American Cancer Society (ACS) guidelines support screening in a similarly defined high-risk population, with the proviso that screened individuals should be in good health. [32] The USPSTF recommendation statement, published in 2014, supported LDCT screening for adults aged 55 -80 years who have a ≥30 pack-year cigarette smoking history, and either smoke currently or quit smoking within the past 15 years. [11] The decision to extend the age range beyond that of the NLST (ages 55 -74 years) was based on the outcomes of a statistical comparative modelling study conducted by de Koning et al, [22] which suggested that continuation of annual screening until the age of 80 years would be advantageous.…”

“…Professional Societies' Guidelines for LC Screening [25] Society (Reference) Recommendation Grade NCCN [19] Annual LDCT in high-risk individuals Group 1: age 55 -79 y with >30 pack-years, current or former smokers who quit within the past 15 y Group 2: age >50 y with >20 pack-years and 1 additional risk factor * B USPSTF [12] Annual LDCT in high-risk individuals: age 55 -80 y with >30 pack-years, current or former smokers who have quit within the past 15 y † B ACCP/ASCO [17] Annual LDCT in high-risk individuals: age 55 -74 y with >30 pack-years, current or former smokers who quit within the past 15 y, but only in settings that can provide multidisciplinary care similar to that provided in the NLST 2B ACS [32] Annual LDCT in high-risk individuals: age 55 -74 y with >30 pack-years, current or former smokers who quit within the past 15 y, who are in good health B AATS [33] Annual Overdiagnosis refers to the detection of a cancer that would not otherwise have become clinically relevant during the patient's lifetime. The extended follow-up data for 16 years from the Mayo Lung Project, which demonstrate a persistent excess of cancers in the screened group compared with the control, suggest that overdiagnosis does occur.…”