Lung cancer guidelines could expand CT screening pool to 94 million

A lung screening and surveillance task force, established by the American Association for Thoracic Surgery and led by medical professionals from Brigham and Women's Hospital (BWH) in Boston, strongly recommended new guidelines for lung cancer screening in the June 20 online edition of the Journal of Thoracic and Cardiovascular Surgery.

The new guidelines reflect results of the National Lung Screening Trial (NLST), and expand eligibility to wider pool of at-risk adults. The AATS guidelines recommend an annual CT lung cancer screening exam for:

• 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;
• 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
• Long-term lung cancer survivors up to the age of 79 (to detect a second case of primary lung cancer).

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. The AATS guidelines also address lung cancer survivors.

In total, under the AATS recommendations, 94 million Americans are now eligible for screening, BWH said in a release. However, the AATS task force recommends that screening should not be performed for individuals with conditions that would preclude successful treatment for lung cancer.

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

The 14-member task force is made up 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 U.S. and Europe, a review of current literature and discussions of clinical practices. The work of the task force was funded by the AATS.

For more information of how the NLST has impacted clinical practice, read "National Lung Screening Trial: A Giant Leap for Lung Cancer Screening--At Baby-step Pace" from the November 2011 issue of Health Imaging.