The National Comprehensive Cancer Network (NCCN)—a not-for-profit alliance of 21 cancer centers—has released guidelines for lung cancer screening. The guidelines recommend screening with helical low-dose computed tomography (LDCT) for selected patients at high risk of the disease.
Lung cancer is the leading cause of cancer death among both men and women in the United States. The disease is often detected at an advanced, difficult-to-treat stage.
Cancer screening involves the use of tests to detect cancer at an early stage in people who don’t have any symptoms of the disease. For cancers such as breast cancer, colorectal cancer, and cervical cancer, screening has contributed to decreased rates of cancer death. Understandably, there has also been a great deal of interest in whether lung cancer screening with tests such as CT scans could reduce lung cancer mortality.
Promising results for screening with helical low-dose CT were published earlier this year in the New England Journal of Medicine. The National Lung Screening Trial (NLST) enrolled current and former heavy smokers. Study participants were screened with either chest x-rays or low-dose spiral CT. People in the CT group were 20% less likely to die of lung cancer.
Based on review of the NLST and other studies, the NCCN guidelines for lung cancer screening recommend screening with helical low-dose CT for selected individuals at high risk of lung cancer.Specifically, the NCCN panel recommended annual screening for people between the ages of 55 and 74 who have a history of at least 30 pack-years of smoking (a pack-year is equivalent to smoking a pack per day for a year), and who, if they are no longer smoking, quit within the last 15 years. Some other high-risk people may also be candidates for screening, but with less evidence to support screening.
The NCCN does not recommend routine lung cancer screening for people at low or moderate risk of lung cancer.
Other organizations—such as the American Cancer Society—have still not completed their review of the most recent lung cancer screening data. People who have questions about the potential risks and benefits of screening are advised to discuss the issue with their physician.