(HealthDay News) — The US Preventive Services Task Force (USPSTF) recommends that high-risk asymptomatic adults aged 55 to 80 years should undergo low-dose computed tomography (CT) screening for lung cancer. This recommendation statement is based on the results of a modeling study published online Dec. 31 in the Annals of Internal Medicine.
Harry J. de Koning, MD, from the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues used data from five independent models to examine the benefits and harms of CT screening for lung cancer among those aged 45 to 90 years. A total of 576 scenarios with varying eligibility criteria and screening intervals were included.
The most advantageous strategy, including screening for 55- to 80-year-old ever smokers with 30 or more pack-years exposure, would lead to 50% of cases being detected at stage I/II and a 14% reduction in lung cancer mortality. Findings also indicate that screening would avert 497 deaths and 5,250 life-years gained per 100,000-member cohort.
Researchers also determined that this screening strategy would result in 67,550 false-positive tests, 910 biopsies or surgeries for benign lesions, and 190 overdiagnosed cases of cancer.
According to results of a sensitivity analysis, the number of averted cancer deaths varied from 177 to 862 across models, while the number of overdiagnosed cases varied from 72 to 426.
Based on the findings, the USPSTF recommends annual lung cancer screening with low-dose CT for asymptomatic adults aged 55 to 80 years with a 30 pack-year history and who currently smoke or quit within the last 15 years. Once a person has not smoked for 15 years or develops a health issue that limits life expectancy or the ability to undergo curative lung surgery, screening should be discontinued.
“It’s clear that the longer and the more a person smokes, the greater their risk is for developing lung cancer,” Michael LeFevre, MD, MSPH, Task Force co-vice chair, said in a statement. “When clinicians are determining who would most benefit from screening, they need to look at a person’s age, overall health, how much the person has smoked, and whether the person is still smoking or how many years it has been since the person quit.”
- de Koning HJ, Meza R, Plevritis SK, et al. Benefits and Harms of Computed Tomography Lung Cancer Screening Strategies: A Comparative Modeling Study for the U.S. Preventive Services Task Force. Ann Intern Med. 2013; doi:10.7326/M13-2316.
- Moyer VA. Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2013; doi:10.7326/M13-2771.