USPSTF issues final lung cancer screening recommendation

The United States Preventive Services Task Force (USPSTF) has finalized its recommendation that individuals at high risk for lung cancer undergo annual low-dose lung CT screening.

The final recommendation essentially follows USPSTF's draft recommendation issued in July that adults ages 55 through 79 with a 30 pack-year smoking history (or have quit in the past 15 years) undergo screening.

The final recommendation was published online Dec. 31 in the Annals of Internal Medicine.

"Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year," Task Force Chair Virginia Moyer, M.D., said in a announcement following the publication of the draft recommendations. "Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable."

There were only a couple of changes from the draft version of the recommendation statement in response to public comments. For example, there were concerns expressed about possibility that recommending annual lung CT screening could enable individuals to continue smoking because of the perception that medical care could mitigate its risks.

"It's very clear that the best way to prevent lung cancer deaths is to quit smoking," Task Force Vice-Chair Michael Lefevre, M.D., told in MedPage Today. "So we have that emphasized much more significantly, particularly in the section called clinical considerations, to make sure people don't think this is an excuse to keep smoking."

USPSTF also added a section on implementation of a screening program, emphasizing the need for monitoring this implementation, quality assurance in diagnostic imaging, and appropriate follow-up to replicate the benefits observed in the NLST in the general population. USPSTF also clarified that, in addition to age and smoking history, healthcare providers should consider risk factors such as occupational exposure, family history, and history of other lung disease when assessing patients' risks for lung cancer.

To learn more:
- read the final recommendation in the Annals of Internal Medicine
- read the USPSTF announcement (.pdf)
- see the article in MedPage Today

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