New Guidelines: More Americans Should Undergo Lung Cancer Screenings
In a new update to its guidelines, the American Cancer Society is recommending that an additional 5 million Americans, both current smokers and former smokers, should undergo annual screenings for lung cancer. Lung cancer is the number one cancer killer in the United States, and these screenings aim to detect the disease at an earlier stage when it is more treatable.
The broadened recommendations apply to about 19 million people who could benefit from low-dose computed tomography (CT) scans. CT scans provide detailed images of the lungs, allowing for improved cancer detection. The new guideline also recommends that people continue to get annual scans even if they quit smoking more than 15 years ago, overturning the previous recommendation to discontinue screening after 15 years of quitting.
The updated guideline, published in the American Cancer Society’s journal, also expands the age range for screening. Previously, screenings were recommended for people between the ages of 55 and 74, but now, the guideline recommends screening for people between the ages of 50 and 80.
Robert Smith, senior vice president for early cancer detection science at the American Cancer Society, explained that the change reflects the fact that lung cancer risk continues to rise as former smokers age, regardless of how long it has been since they quit smoking. The risk, although lower than if smokers had continued to smoke, is still significant.
The updated guideline also includes people with a less intense smoking history. The new recommendation applies to individuals who smoked or used to smoke the equivalent of one pack of cigarettes a day for 20 years, whereas the previous guideline was for people who smoked the equivalent of one pack a day for 30 years.
Lung cancer has been a leading cause of cancer-related deaths in the United States, accounting for 20% of all cancer fatalities. The mortality rate for lung cancer has decreased due to declining smoking rates, but it remains a significant health concern. In 2023, the American Cancer Society estimates that there will be around 238,000 new cases of lung cancer and over 127,000 deaths.
The new guidelines aim to reduce lung cancer deaths by offering better opportunities for early detection. CT scans and medications such as immunotherapy have emerged as important tools in the fight against lung cancer. Immunotherapy harnesses the immune system to attack cancer cells.
Experts emphasize the importance of detecting lung cancer before it spreads, as the survival rates significantly drop once the cancer has metastasized. The five-year survival rate for non-small-cell lung cancer is 65% for patients in which the cancer has not spread outside the lung. However, the survival rate decreases to 37% and 9% when the cancer spreads to nearby parts of the body or more distant areas, respectively.
The updated guideline has been praised by experts in the field. Julie Barta, an assistant professor at Thomas Jefferson University Hospitals, called it a “really important step forward” in reducing lung cancer deaths. Barta emphasized that the recommendation for former smokers to continue screenings beyond 15 years after quitting removes a potential barrier to screening.
The new guideline is also in closer alignment with the recommendations of the United States Preventive Services Task Force. Most insurers must cover annual lung-cancer screenings as endorsed by the task force.
While lung-cancer screening carries some risks, experts believe that the benefits outweigh them. False positives and over-diagnosis can occur, leading to unnecessary tests and treatments. However, the current rate of false positives is similar to that of mammograms. The challenge now lies in improving the uptake of lung-cancer screening, which currently stands at only 10% of eligible individuals.
Education and awareness campaigns need to emphasize that screenings are not a one-and-done process and should be conducted annually, similar to mammograms for breast cancer. The American Cancer Society recognizes the need to do a better job of reminding individuals about the importance of regular screenings.
By broadening the guidelines for lung cancer screenings, the American Cancer Society hopes to reduce the number of lung cancer deaths in the United States and provide better opportunities for early detection and treatment.