The American Lung Association has released new interim guidelines to assist physicians, patients, and the public in their discussions about lung cancer screening. Developed by the American Lung Association’s Lung Cancer Screening Committee chaired by Jonathan Samet, MD, MS, from the University of Southern California, the report reviews current scientific evidence on lung cancer screening and provides important guidance to physicians and the at-risk public about getting screened for lung cancer.
Low-dose computed tomography is a promising clinical strategy for the detection of presymptomatic lung cancer in individuals at the highest risk for lung cancer, reducing deaths by 20% compared to chest x-ray, according to findings from the National Lung Cancer Screening Trial (NLST) recently released by the National Cancer Institute.1 These findings have led to widespread use of CT for lung cancer screening.
Criteria for Lung Cancer Screening
The American Lung Association’s Lung Cancer Screening Committee developed recommendations to facilitate decision-making, particularly for those with chronic lung diseases, while research on CT screening continues. Based on the NLST findings, the Lung Association recommends lung cancer screening with low-dose CT scans for people who meet the criteria, which include the following: current or former smokers (aged 55 to 74 years), with a smoking history of at least 30 pack-years (that is, an average of a pack a day for 30 years) and with no history of lung cancer.
The Lung Association recognizes that while low-dose CT scans may save lives, screening for lung cancer should not be recommended for everyone, as many known and unknown risks may be associated with the screening and subsequent medical evaluation. “Never starting smoking and quitting smoking still remain the best ways to prevent lung cancer,” said Norman H. Edelman, MD, Chief Medical Officer of the American Lung Association.
Other recommendations made in ALA’s report include referring patients to facilities that have experience in conducting low-dose CT scans and that employ multidisciplinary teams to provide comprehensive follow-up. The Lung Association also urges hospitals and screening centers to establish ethical policies for advertising and promoting lung cancer CT screening services.
Albert Rizzo, MD, Board Chair for the American Lung Association, said, “Our hope is that this report will guide the public on this very important personal and public health issue. We believe that the report and the educational materials that will stem from it will be invaluable to the tens of millions at risk for lung cancer.”
The full American Lung Association Interim Report on Lung Cancer Screening and related educational materials are available at http://www.lung.org/lung-disease/lung-cancer/lung-cancer-screening-guidelines. ■
1. The National Lung Screening Trial Research Team: Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395-409, 2011.