New USPSTF Lung Cancer Screening Criteria Cover More High-Risk Patients

Updated lung cancer screening recommendations from the US Preventive Services Task Force (USPSTF) include 2 changes that will nearly double the number of people eligible for screening, according to a statement from the USPSTF.

The new recommendations include yearly low-dose computed tomography (CT) scans for people aged 50 to 80 years old, rather than starting at 55, as past guidelines suggest. It also reduces the pack-years of smoking history that make a person eligible, dropping the baseline from 30 to 20. A pack-year is the equivalent of smoking an average of 1 pack of cigarettes each day for a year.

These changes to the USPSTF recommendations have potential to impact many lung cancer patients. In 2020, an estimated 228,820 people in the United States were diagnosed with lung cancer. It is the leading cause of cancer death in the U.S population, with an estimated 135,720 people in the U.S. dying from lung cancer in 2020. In line with previous guidelines, people who currently smoke or have quit within the past 15 years should also be screened yearly.

“The Task Force reviewed new evidence that shows screening can help many more people who are at high risk for lung cancer,” says USPSTF member Michael J. Barry, MD. “By screening people who are younger and who have smoked fewer cigarettes, we can save more lives and help people remain healthy longer.”

Smoking is estimated to account for approximately 90% of all lung cancer cases, making smoking status and history a key factor for assessing a patient’s risk. Other risk factors include environmental exposures as well as health factors like prior treatment with radiation therapy, noncancer lung diseases, and family history.

The eligibility expansion in the new recommendations will be particularly helpful for earlier detection of lung cancer in Black patients and women. Both groups have been shown to smoke fewer cigarettes than white men, but data also show that Black people face a higher risk of lung cancer than white people. Many more patients in both groups will be eligible for screening under the new guidelines.

“The changes to this recommendation mean more Black people and women are now eligible for lung cancer screening, which is a step in the right direction,” USPSTF member John B. Wong, MD, said in a “However, to save more lives and ensure that everyone who would benefit is screened, it is critical that screening is implemented broadly and equitably.”

Reference

Lung Cancer: Screening. U.S. Preventive Services Task Force. Published March 9, 2021. Accessed March 10, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening