Lung Cancer Screening Update
Lung cancer is the third most common cancer in the United States, and also one of the most lethal, mainly because it is usually diagnosed at a late stage when it has already spread elsewhere in the body. But proposed changes to lung cancer screening could make a difference.
Extended Screening Eligibility The screening updates come from the U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts in prevention and evidence-based medicine. The USPSTF draft recommendation proposes that annual lung cancer screening with computed tomography (CT) scans be extended to people between ages 50 and 80 who are current smokers and have a 20 pack-year smoking history. “The latter refers to a person who has smoked a pack of cigarettes per day for 20 years, or those who have smoked two packs per day across 10 years,” explains Cardinale Smith, MD, associate professor of geriatrics and palliative care at Mount Sinai. “The new recommendation also applies to people who quit smoking within the past 15 years but have the same pack-year history. The recommendation excludes people who quit smoking more than 15 years ago, and those whose life expectancy wouldn’t be improved by lung cancer surgery.”
The previous USPSTF guidelines, established in 2013, recommended CT screening for people with a 30 pack-year smoking history. The new recommendation is based on data from two large trials suggesting a significant mortality benefit from lung cancer screening.
Slipping Through the Net It is hoped that the new guidelines may increase lung cancer screening among women, who tend to smoke fewer cigarettes than men. The guidelines also could benefit African Americans, who have a greater risk for lung cancer than white people. A 2019 study found that only 17 percent of African-American smokers were eligible for screening under the current screening guidelines, compared with 31 percent of white smokers. “The disparity persisted in smokers who had been diagnosed with lung cancer: 32 percent of African Americans were eligible, compared to 56 percent of white people,” Dr. Smith notes. “There is evidence that African Americans who smoke take up the habit later and smoke fewer cigarettes per day than white people, which may be why they are currently under-screened. They also are less likely than white people to quit smoking, possibly because they may have less access to smoking cessation counseling.”
Balancing Benefits and Harms While smoking causes about 85 percent of lung cancer cases in the United States, there are other risk factors for the disease—for example, having a family history of lung cancer, and long-term exposure to radon (a naturally-occurring radioactive gas), asbestos, coal smoke, and other airborne pollutants. If you are a current or former smoker, or have any other lung cancer risk factors, you may want to ask your doctor whether you should be screened. “If you do, it is important to discuss with your doctor the risks of screening as well as the benefit of early diagnosis,” Dr. Smith advises. “For example, a false-positive result may result in stressful follow-up testing and procedures that reveal no cancer is present.”
It also is important to consider the treatment options for lung cancer, which include chemotherapy, radiation, and surgery. “Research suggests that older adults may be more likely to suffer unpleasant side effects from radiation and chemotherapy—for example, nausea, vomiting, and fatigue,” Dr. Smith says. “And while a relatively healthy senior might withstand lung cancer surgery quite well, a person with heart problems or diabetes might not.” So before you decide on screening, think carefully about whether you would want to undergo treatment if you were diagnosed with lung cancer, particularly if you have other serious health conditions and/or a limited life expectancy.
The post Lung Cancer Screening Update appeared first on University Health News.
Read Original Article: Lung Cancer Screening Update »
