Screening for Lung Cancer
- Study type
- Clinical guideline
- Study name
- USPSTF Lung Cancer Screening 2021
- Design
- Recommendation statement (clinical guideline) based on a systematic review and a collaborative modelling study
- Source
- JAMA · 2021
In plain words
Lung cancer is one of the most common and deadliest cancers, and its main cause is smoking. When lung cancer is found early, it is easier to treat. This guideline recommends that people aged 50 to 80 who have a heavy smoking history (20 pack-years) and still smoke or quit within the past 15 years have a low-dose CT scan of the lungs every year. Screening should stop once 15 years have passed since quitting, or if you have a serious health problem that would not allow curative lung surgery. Ask your doctor whether screening is right for you.
Key points
Key guideline recommendations
- B
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
- B
Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
Study population
Adults aged 50 to 80 years with a 20 pack-year smoking history who currently smoke or have quit within the past 15 years.
Endpoints
To update its 2013 recommendation, the Task Force (USPSTF) commissioned a systematic review on the accuracy of lung cancer screening with low-dose computed tomography (LDCT) and on its benefits and harms. A collaborative modelling study was also performed to determine the optimal ages to start and stop screening and the optimal screening interval, and to compare the relative benefits and harms of different strategies, including modified versions of multivariable risk prediction models.
Safety and side effects
The abstract does not report detailed statistics on harms of screening. The commissioned systematic review examined the benefits and harms of screening; details are in the full text.
Clinical significance and place in guidelines
This statement updated the 2013 USPSTF recommendation and broadened eligibility: the starting age was lowered from 55 to 50 years and the minimum smoking history from 30 to 20 pack-years. Annual LDCT screening of high-risk people is recommended with grade B. The abstract gives no information on endorsement of this recommendation by other clinical guidelines or its status in other countries; before applying it in practice, local guidelines and access to LDCT should be checked.
Limitations
The published abstract does not describe the limitations of the evidence in detail; details are in the full text. The recommendation was developed for the US population, and its generalisation to other health systems requires evaluation.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.