lung cancer screening

New lung cancer screening guidelines approved for older smokers

Guidelines recommending annual low-dose CT lung cancer screening for older smokers have been approved by the US Preventive Services Task Force. The recommendations apply to individuals aged between 55 and 80 who are at high risk for lung cancer as a result of heavy smoking.

The guidelines are published in the journal Annals of Internal Medicine.

According to the American Cancer Society, approximately 228,190 new cases of lung cancer will have been diagnosed during 2013, with 159,480 deaths from the disease. This accounts for around 27% of all cancer deaths.

Background information from the guidelines states that around 85% of all cases of lung cancer are caused by smoking, and the risk of lung cancer increases with age, particularly for those aged over 55.

Dr. Michael LeFevre, co-vice chair of the US Preventive Services Task Force (USPSTF), says these factors suggest that the longer a person smokes, the higher their risk is for developing lung cancer.

Guidelines recommending annual low-dose CT lung cancer screening for older smokers have been approved by the US Preventive Services Task Force. The recommendations apply to individuals aged between 55 and 80 who are at high risk for lung cancer as a result of heavy smoking.

The guidelines are published in the journal Annals of Internal Medicine.

According to the American Cancer Society, approximately 228,190 new cases of lung cancer will have been diagnosed during 2013, with 159,480 deaths from the disease. This accounts for around 27% of all cancer deaths.

Background information from the guidelines states that around 85% of all cases of lung cancer are caused by smoking, and the risk of lung cancer increases with age, particularly for those aged over 55.

Dr. Michael LeFevre, co-vice chair of the US Preventive Services Task Force (USPSTF), says these factors suggest that the longer a person smokes, the higher their risk is for developing lung cancer.

He adds:

“When clinicians are determining who would most benefit from screening, they need to look at a person’s age, overall health, how much the person has smoked, and whether the person is still smoking or how many years it has been since the person quit.”

Low-dose CT scanning ‘more accurate’
The 2004 lung cancer screening recommendation from the USPSTF stated that the “evidence was insufficient to recommend for or against screening for lung cancer in asymptomatic persons with LDCT (low-dose computed tomography), chest radiography, sputum cytologic evaluation or a combination of these tests.”

With the aim of updating these recommendations, a panel from the USPSTF reviewed more than 33 studies involving current or former smokers who were at average or high risk for developing lung cancer.

The analysis included a study of more than 50,000 people who were a part of the National Lung Screening Trial.

From their research, the panel found that low-dose computed tomography (CT) lung cancer screening was more accurate in identifying the disease in its early stages, compared with alternative screening tests.

Their findings have led the USPSTF to “recommend annual screening for lung cancer with low-dose computed tomography in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.”

A 30-pack year is the equivalent to one pack a day for 30 years, or two packs a day for 15 years.

Screening not recommended when smoking ceased for 15 years
However, they note that screening should be stopped once a person has not smoked for 15 years or develops a health problem that shortens life expectancy or the willingness or ability to undergo potential lung surgery.

Dr. Virginia Moyer, chair of USPSTF emphasizes that it is important to assess a patient’s overall health to determine whether screening is appropriate.

“The benefit of screening may be significantly less in people with serious medical problems and there is no benefit in screening someone for whom treatment is not an option,” she says.

“In these people, screening may lead to unintended harms such as unnecessary tests and invasive procedures.”

She also adds that although screening for lung cancer is beneficial, it should not be seen as an alternative to giving up smoking.

Source: medical news today

Lung cancer scans urged for some smokers, not all

Certain current or former heavy smokers should start getting yearly scans for lung cancer to cut their risk of death from the nation’s top cancer killer, government advisers said Monday — even as they stressed that the tests aren’t for everyone.

The long-anticipated decision by the influential U.S. Preventive Services Task Force says these CT scans of the lungs should be offered only to people at especially high risk: those who smoked a pack of cigarettes a day for 30 years or an equivalent amount, such as two packs a day for 15 years — and who are between the ages of 55 and 80.

That’s roughly 10 million people, but not all of them qualify for screening, said task force vice chairman Dr. Michael LeFevre, a University of Missouri family physician. Even those high-risk people shouldn’t be scanned if they’re not healthy enough to withstand cancer treatment, or if they kicked the habit more than 15 years ago.

Lung cancer kills nearly 160,000 Americans each year. Smoking is the biggest risk factor, and the more and longer people smoke, the higher their risk. Usually, lung cancer is diagnosed too late for treatment to succeed, but until now there hasn’t been a good means of early detection.

The newly recommended screening could prevent as many as 20,000 deaths a year, LeFevre said — if it’s used correctly.

That estimate assumes good candidates seek the scans. There’s no way to know if people at the highest risk will, or if instead the overly anxious will flood testing centers.

Screen the wrong people, “and we could see more harm than good,” LeFevre cautioned. “There’s a lot of room for what I would call people exploiting the recommendation. I can imagine a street-corner imaging center advertising to invite people in.”

Why not screen younger or lighter smokers? There’s no data to tell whether they’d be helped. Lung cancer is rare before age 50, and the major study that showed screening could save lives enrolled only heavy smokers starting at age 55.

But screening isn’t harm-free. A suspicious scan is far more likely to be a false alarm than a tumor, LeFevre noted. Yet patients may undergo invasive testing to find out, which in turn can cause complications.

Moreover, radiation accumulated from even low-dose CT scans can raise the risk of cancer. And occasionally, screening detects tumors so small and slow-growing that they never would have threatened the person’s life.

While screening clearly can benefit some people, “the best way to avoid lung cancer death is to stop smoking,” LeFevre added.

The task force proposed the screenings last summer but published its final recommendation Monday in the journal Annals of Internal Medicine. That clears the way for insurers to begin paying for the scans, which cost between $300 and $500, according to the American Lung Association.

Under the Obama administration’s health care law, cancer screenings that are backed by the task force are supposed to be covered with no copays, although plans have a year to adopt new recommendations.

Source: Yahoo news