USPSTF's new lung cancer screening guidance lowers starting age

By Kate Madden Yee, AuntMinnie.com staff writer

March 9, 2021 -- The U.S. Preventive Services Task Force (USPSTF) has released an updated, final recommendation for CT lung cancer screening that lowers the starting age from 55 to 50 and adjusts smoking history from 30 pack years to 20 pack years. The final recommendation was published March 9 in JAMA.

The guidance updates the task force's 2013 recommendation. It now states that adults between the ages of 50 and 80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years should undergo annual screening for lung cancer with low-dose CT. As in 2013, the task force has given the guidance a "B" grade, which translates to the following:

"The USPSTF concludes with moderate certainty that annual screening for lung cancer with low dose CT has moderate net benefit in persons at high risk of lung cancer based on age, total cumulative exposure to tobacco smoke, and years since quitting smoking," it wrote. "The moderate net benefit of screening depends on limiting screening to persons at high risk, the accuracy of image interpretation being similar to or better than that found in clinical trials, and the resolution of most false-positive results with serial imaging rather than invasive procedures."

For the update, the USPSTF conducted a review of 220 studies that investigated screening for lung cancer with low-dose CT, including data from the National Lung Screening Trial (NLST) and the Netherlands-Leuvens Longkanker Screenings Onderzoek (NELSON) trials. The group also commissioned a modeling study from the Cancer Intervention and Surveillance Modeling Network (CISNET) Lung Cancer Working Group to address questions about when to start screening, the best screening interval, and the benefits and harms of different screening strategies.

https://www.nytimes.com/2021/03/09/health/lung-cancer-smoking-screenings-black-women-younger-adults.html

https://www.cdc.gov/cancer/lung/basic_info/screening.htm

https://www.acr.org/Clinical-Resources/Lung-Cancer-Screening-Resources/FAQ

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21172