New lung cancer screening guidelines expand the list of people who should get tested each year
According to the American Cancer Society, even heavy smokers who quit smoking at least 15 years ago are at risk of developing this deadly disease. Only a fraction of people at high risk of lung cancer are screened for the disease, even though it kills more people in the United States than breast, colon and prostate cancer combined. New guidelines from the American Cancer Society will enable millions more people to qualify for regular imaging tests that can detect cancer early and save lives.
With one notable exception, the new guidelines reflect existing recommendations from the influential US government. Preventive Services Task Force. In 2021, the panel said people aged 50 to 80 who have smoked at least 20 "packs per year" and have continued to smoke or quit smoking in the past 15 years should be screened annually with low-dose X-rays CT.
Even heavy smokers who quit smoking 15 years ago or earlier should undergo annual testing, according to new guidelines released on Wednesday.
Experts say previous guidelines were based on a false assumption: The longer it takes a person to quit smoking, the lower their risk of cancer.
A careful look at data from people diagnosed with lung cancer shows that the risk of developing cancer increases with age, even among those who stopped smoking 15 years or more ago, said Dr.William Dahut, chief scientific officer of the American Cancer Society and one of the authors of the guidelines.
While the lungs of ex-smokers might have become a little better initially, that effect wasn’t lasting, he said.
“People developed a false sense of security,” which may have contributed to the “abysmally low” rates of screening, Dahut said.
A 2022 report from the American Lung Association indicated that only 5.8% of Americans had been screened for lung cancer and that in some states, rates were as low as 1%.
“Compare that to mammograms, which about two-thirds of women get after a certain age,” she said.
Is lung cancer screening worth it?
Under previous guidelines, 14.3 million people in the United States were eligible for screening. Dahut said the new recommendation would cover an additional 5 million people. Many smokers and ex-smokers don't realize that a simple, low-dose CT scan can detect lung cancer early enough to save their lives. Even among the primary care physicians who were supposed to order the tests, “there was confusion,” Dahut said. Typically, Medicare and commercial insurance companies pay for the tests recommended by the task force. However, Dahut noted that it could take some time to cover the additional people covered by the new guidelines.
Dr.Chi-Fu Jeffrey Yang, a thoracic surgeon at Massachusetts General Hospital in Boston, has conducted informal surveys to find out why people might not be checked.
“We asked people if they had heard of it. “Nobody did it,” she said. "But everyone has heard about mammograms for breast cancer, colonoscopies for colon cancer, and Pap tests for cervical cancer."
The current low testing rates are a “national tragedy,” says Dr.David Yankelevitz, director of the Division of Lung Biopsy at the Icahn School of Medicine. “This should certainly be our best weapon in the fight against cancer. The fact that such a small percentage is monitored is absolutely appalling and a huge mistake.”
I would like the selection criteria to be expanded even further, especially for women, blacks and Indians. Studies have shown that these groups are more likely to develop lung cancer with less exposure or at a younger age.
“They have a higher risk at lower ages and lower pack years,” Yankelevitz said.
Director of the Tobacco Treatment and Cancer Screening Clinic at Johns Hopkins Medicine in Baltimore, Dr. Panagis Galiatsatos, called the shift in screening standards to cover those who had quit smoking a long time ago "huge."
"A lot of people who smoked two packs of cigarettes a day in their teens and early adulthood and are now in their 40s and 50s don't consider themselves smokers," the man stated. However, they must be scanned.