Heather Bedard, C.H.E.
Lung cancer screening is recommended for adults aged 50-80 years who have a 20 pack-year smoking history, who currently smoke, or who have quit in the past 15 years.[1] This recommendation is made by the United States Preventative Task Force (USPTF). Interestingly enough, this recommendation was changed from a 30 pack-year smoke history to 20 pack-year smoke history in 2021. This is to increase screening eligibility for both men and women by 6-9%. However, this screening only averts 88-177 more cancer deaths per 100,000 people and come with a massive 10-50% increase in radiation induced lung cancer deaths and 14-25 more misdiagnosed cases per 100,000.
[2] A systematic review of the USPTF on screening for lung cancer with low-dose computed tomography showed that for every 1,000 people screened, 17 false positives resulted in unnecessary invasive procedures and harms included anxiety and distress.[3] The USPTF also states that, “…evidence does not indicate that screening leads to lower rates of smoking cessation or continued abstinence or to higher rates of relapse.”
It would seem that more effort should be placed into smoking abstinence with zero risk of adverse events rather than increasing screening parameters. Overall, even with the new screening parameters, lifespan is only increased 0.5%. Based on the risk to benefit ratio of this screening test, I wouldn’t not recommend this screening regardless of your smoking habits.
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[1]https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
[2] Meza R, Jeon J, Toumazis I, et al. Evaluation of the Benefits and Harms of Lung Cancer Screening With Low-Dose Computed Tomography: A Collaborative Modeling Study for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Mar. (Evidence Syntheses, No. 198tr.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK568586/
[3] Jonas DE, Reuland DS, Reddy SM, et al. Screening for Lung Cancer With Low-Dose Computed Tomography: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2021;325(10):971-987. doi:10.1001/jama.2021.0377