
Lung cancer is the leading cause of cancer-related deaths in the United States. Although the death rate has declined some over the last few decades, the screening rate for lung cancer remains low. According to the American Lung Association (ALA), 14 million U.S. adults qualified for lung cancer screening in 2021, but only less than 6% received it.
With this disparity in mind, the American Cancer Society (ACS) revised its guidance for lung cancer screening. An increase in screening will lead to more cases of early detection, which is crucial to successful treatment and survival. The organization announced its updated guidelines as part of Lung Cancer Awareness Month in November 2023, publishing them in CA: A Cancer Journal for Physicians.
Major changes to the new guideline, which replaces the previous version from 2013, include:
· Lowering its recommended age of asymptomatic current or former smokers to begin annual lung cancer screenings from 55 years to 50 years.
· Raising its recommended age of asymptomatic current or former smokers to continue screening for lung cancer from 74 years to 80 years.
· Changing its definition of a high-risk person from a 30-pack-year history to a 20-pack-year history (average of 20 cigarettes a day).
· Expanding eligibility to all former smokers, thereby removing its requirement of people to have quit within 15 years of screening.
The ACS referenced the latest data and research when making its revisions. By moving up the screening start age to 50 years, the ACS predicts a 15% reduction in lung cancer mortality in men who are 50-54 years old. By eliminating the 15-year timeline for former smokers, it predicts a 37% increase in screening exams, a 21% increase in survival rate and a 19% increase in life-years gained per 100,000 people who have lung cancer.
“This updated guideline continues a trend of expanding eligibility for lung cancer screening in a way that will result in many more deaths prevented by expanding the eligibility criteria for screening to detect lung cancer early,” said Robert Smith, MD, senior vice president, early cancer detection science at the American Cancer Society and lead author of the lung cancer screening guideline report.
Health care professionals should consult with all eligible patients about the benefits, risks and considerations of a low-dose CT scan. The revised ACS guideline does not automatically trigger policy change. Insurance coverage is dictated by payors and the U.S. Preventive Services Task Force, which maintains the eligibility requirement for former smokers to be within 15 years of quitting. This could create a disadvantage for lower-income individuals who are at risk and responsible for paying out-of-pocket for their screening.
“[This is] critical to identify all individuals who can benefit from the early detection of lung cancer,” said Lisa Lacasse, president of ACS Cancer Action Network. “ACS CAN will continue to work to improve access to care and lung cancer screening at no cost for any person at risk of the disease to decrease lung cancer deaths and help end cancer as we know it, for everyone.”