Medical groups revise lung cancer CT screening guidelines

Amid debate over the merits of annual CT scans to look for lung cancer in smokers, three medical groups are recommending them for one particular group: current or former heavy smokers aged 55 to 74.

Regular scans for those younger, older or nonsmokers pose more risk than benefits. The advice comes from the American College of Chest Physicians, the American Society of Clinical Oncology and the National Comprehensive Cancer Network.

Heavy smokers were defined as those who smoked at least one pack of cigarettes a day for at least 30 years.

About 4,000 lives a year could be saved if all 8 million Americans eligible for screening under this criteria got it, Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center in New York told The Associated Press.

Last year the American Cancer Society said heavy smokers age 55 to 74 "may consider" CT screening but should discuss risks and benefits with their physicians.

In research published online May 20 in the Journal of the American Medical Association, Bach and colleagues looked at 591 citations in a review of relevant literature and noted potential harms associated with low-dose CT screening (LDCT), including over-diagnosis of  cancers that would not affect the patient during his or her lifetime, radiation exposure, anxiety and cost, Health Imaging reports.

The anxiety stems from false positives that can occur with CT scans. Regular chest X-rays also can detect lung cancer, but the images are not as detailed and it also can produce false positives.

Then there's the cost and the fact that LDCT is not covered as a standard test. "It is difficult to recommend this test when patients may be burdened by the cost of this test year after year," Chao Huang, M.D., a lung cancer specialist at The University of Kansas Cancer Center, said in a statement. 

New research at Rush University Medical Center, however, found that the screening would reduce lung cancer deaths and cost insurers less than colorectal, breast and cervical cancer screenings. The researchers concluded that the screening "makes sense" for insurers.

To learn more:
- read the AP article
- check out Health Imaging's report
- access the JAMA research report
- read the ABC News report

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