Low-Dose CT Findings Result in New Guidelines for Lung Cancer Screening

New research shows that low-dose computed tomography (LD-CT) is beneficial in reducing deaths from lung cancer. Due to this finding, a recent US task force is strongly recommending new guidelines for lung cancer screening.

The lung screening and surveillance task force was established by the American Association for Thoracic Surgery (AATS; Beverly, MA, USA) and led by clinicians from Brigham and Women’s Hospital (BWH; Boston, MA, USA). The guidelines were published June 25, 2012, in the online edition of the Journal of Thoracic and Cardiovascular Surgery (JTCVS).

The AATS task force recommends a yearly lung cancer screening using LDCT for (1) smokers and former smokers between the ages of 55 and 79 who have smoked the equivalent of a pack of cigarettes a day for 30 years; (2) smokers and former smokers between the ages of 50 and 79 who have smoked the equivalent of a pack of cigarettes a day for 20 years and have other factors that raise their risk of developing lung cancer; and (3) long-term lung cancer survivors up to the age of 79 (to detect a second case of primary lung cancer).

David Sugarbaker, MD, the chief of the division of thoracic surgery at BWH and president-elect of the AATS, conceived the idea of creating the guidelines. He said, “This work will result in a greater chance for patients stricken with early lung cancer to receive curative therapy.”

These guidelines differ from the recommendations of other societies because they recommend screening for patients up to the age of 79. Other societies only recommend screening for patients up to the age of 74. These guidelines are also unique because they address lung cancer survivors. In total, under the AATS recommendations, 94 million people in the United States are now eligible for screening. The AATS task force recommended that screening should not be performed for individuals with conditions that would preclude successful treatment for lung cancer.

“Low-dose CT scanning has been proven to save lives,” said Francine Jacobson, MD, MPH, a thoracic radiologist at BWH and a co-chair of the task force. “I hope this recommendation will encourage physicians to use low-dose CT scanning for a broader range of patients.”

Michael Jaklitsch, MD, a thoracic surgeon at BWH and a co-chair of the task force, said, “Lung cancer is an epidemic with over a quarter of a million new cases each year. Now, for the first time in history, there is a clear screening tool that identifies early stages of lung cancer, when treatment is most successful. Our analysis shows this tool of low-dose CT scans to be safe and very cost efficient. Lung cancer screening will save lives, save lungs and inspire many Americans to quit smoking.”

The 14-member task force is comprised of thoracic surgeons, thoracic radiologists, medical oncologists, a pulmonologist, a pathologist, and an epidemiologist. They based their conclusion on a review of screening trials in the United States and Europe, an examination of current literature and discussions of clinical practices. The work of the task force was funded by the AATS.

Related Links:
American Association for Thoracic Surgery
Brigham and Women’s Hospital