July
7, 2020, 12:52 PM CDT By Kelsie
Sandoval
New recommendations
for lung cancer screening would nearly double the number of Americans eligible
for the test, according to guidelines released Tuesday by the U.S. Preventive
Services Task Force.
The draft guidelines
propose lowering the eligibility age for lung cancer screening
to 50 from 55, and lowering the number of years a person smoked an average of a
pack a day (known as “pack years”) to 20 from 30 to qualify for the test.
The new
recommendations will likely result in more women and African Americans becoming
eligible for screenings, the guidelines say.
The shift in smoking
history to 20 pack years will particularly benefit women, Dr. Mara Antonoff, an
assistant professor of thoracic and cardiovascular surgery at MD Anderson
Cancer Center in Houston, said.
“Women seem to
develop lung cancer with lesser exposure than men,” she said.
And broadening the
age criteria will benefit African Americans: “We know that African Americans
have a tendency to develop lung cancer at earlier ages, on average, than
Caucasian individuals,” Antonoff said.
Dr. John Wong, a task
force member and the chief scientific officer at Tufts Medical Center, said,
“New evidence suggests we should be screening or can be screening many more
people at high risk, who are now 50 to 80 years old, with a high-risk smoking
history.”
Lung cancer is No. 1
cause of cancer deaths in
the U.S. for both men and women, according to the American Cancer Society.
The task force, an
independent panel of experts, last updated its guidelines for lung cancer screenings
in 2013.
Dr. Bernard Park,
deputy chief of thoracic surgery at Memorial Sloan Kettering Cancer Center in
New York City, lauded the task force’s methodology for updating the guidelines.
“They had commissioned a systematic review of the literature, as well as some modeling
studies from the cancer intervention and surveillance modeling network to
really try to come up with some evidence-based modifications,” he said.
Although these new
guidelines expand the number of people eligible for screening, getting patients
to participate remains an obstacle.
“It's one thing to
expand the theoretical pool of those that can be screened,” Park said. “The
harder challenge is to actually get those patients screened.”
Screening for lung
cancer involves a low dose CT scan, which makes images of a patient’s lungs to
look for any abnormalities. There has been concern that screening too many
people for lung cancer could lead to false positives, or diagnosis of cancers
that may never cause harm. But Park said these guidelines wouldn’t change the
already low incidence of falsely diagnosing patients.
Antonoff said
physicians need to be more aware of lung cancer screening benefits. “The
education regarding lung cancer screening is a huge problem. It's generally
lacking,” she said.
The publication of
the draft guidelines is part of a larger, collaborative process. Next,
interested parties — such as medical organizations and patient advocacy groups
— can provide feedback. Afterward, the task force will make their final
recommendations. This process generally takes a few months.
CORRECTION: (July 8, 2020, 3:09
p.m. ET): A previous version of this article misstated the institution where
Dr. John Wong is chief scientific officer. It is Tufts Medical Center, not
Tufts University.
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