Medical Experts Expand Lung Cancer Screening Recommendations

March 19, 2021
A young father holds his two children in his arms in a field of flowers

 

The U.S. Preventive Services Task Force (USPSTF) is an independent group of medical experts in primary care and prevention that makes recommendations about clinical preventive services and medications. The group recently expanded recommendations for lung cancer screening. The USPSTF now recommends that adults with a long history of smoking should begin getting annual low-dose CT scans at age 50, which is 5 years earlier than previously recommended.

This update will nearly double the number of people eligible for lung cancer screening. Under USPSTF’s previous recommendations, only about 8 million adults qualified for this important screening (Grady, 2021). Under USPSTF’s new recommendations, nearly 15 million individuals will qualify for lung cancer screening.

 

Who Qualifies Under the New Recommendations?

Under the new recommendations, adults between the ages of 50 and 80 years old who have a 20 pack-year smoking history, and either still smoke or quit within the last 15 years, are recommended to get an annual low-dose CT (an X-ray machine used to scan the lung) to screen for lung cancer.

Smoking history is measured in “pack-years”—smoking an average of 1 pack of cigarettes per day for 1 year (Howard, 2021). Under the new recommendations, this means someone could be screened if they have smoked a pack a day for 20 years, or 2 packs a day for 10 years.

The Affordable Care Act (ACA) requires that private health insurers must cover preventive services, without patient cost-sharing, that have a grade “A” or “B” recommendation from the USPSTF. A grade “A” or “B” indicates that USPSTF strongly recommends or recommends that clinicians provide a service to eligible patients (USPSTF, 2018). The new lung cancer screening recommendations received a grade “B.” Medicare also generally follows the USPSTF recommendations.

In addition to making an estimated 15 million people eligible for lung cancer screening, the new recommendations could help to decrease racial disparities in screening eligibility. While this update will increase the number of people overall eligible for lung cancer screening by 87%, for Black and Hispanic adults the number of people eligible could increase by 107% and 112%, respectively (USPSTF, 2021).

 

The Importance of Lung Cancer Screening

Lung cancer is the leading cause of cancer death in the United States, with more than 135,000 deaths each year (Neegaard, 2021). Generally, the 5-year survival rate for lung cancer is about 20% (McGinley, 2021). However, the survival rate is higher when the disease is caught at the earliest stages when it has not spread and is easier to treat. Current and former smokers are at a higher risk of getting lung cancer. Some people who are at especially high risk get an annual low-dose CT scan to screen for the disease. This screening has been shown to reduce deaths from lung cancer.

Significant outreach and education are needed to ensure that eligible people get screened for lung cancer. While 60% to 80% of people eligible for breast, colon, or cervical cancer screening get checked (Neergaard, 2021), a recent study found that only 14% of people eligible for lung cancer screening under the previous recommendations were actually screened (USPSTF, 2021).

If you think you may be at risk for lung cancer, find a screening program that follows these guidelines and uses low-dose CT scans. Though doctors do not recommend routine screening for adults who have never smoked or smoked fewer than 20 pack-years, anyone can still get lung cancer. Talk to your doctor if you feel that you have an increased risk for lung cancer and are not eligible for screening under current guidelines.

 

Where Can I Find Lung Cancer Resources and Support?

If you are living with lung cancer, are a caregiver to someone with lung cancer, or at a higher risk for lung cancer, the Cancer Support Community offers a variety of resources to help.

Visit our lung cancer page for information about the disease, including more information about risk factors, testing, different treatment options to help you make informed decisions, and how to cope. On this page you can find our Frankly Speaking About Cancer library, which includes publications and videos.

 

References

Grady, D. (2021). Yearly lung cancer scans are advised for people 50 and over with shorter Smoking Histories. The New York Times. Retrieved from https://www.nytimes.com/2021/03/09/health/lung-cancer-smoking-screenings-black-women-younger-adults.html

Howard, J. (2021). US Task Force Recommends Lung Cancer Screening Start Earlier, include People with Shorter Histories of Smoking. Retrieved from https://www.cnn.com/2021/03/09/health/lung-cancer-screening-uspstf-wellness/index.html

McGinley, L. (2021). Millions more smokers and ex-smokers should receive free annual screenings for lung cancer, a federally appointed task force says. The Washington Post. Retrieved from https://www.washingtonpost.com/health/2021/03/09/lung-cancer-screening/.

Neergaard, L. (2021). Health panel expands lung cancer screening for more smokers. The Washington Post. Retrieved from https://www.washingtonpost.com/health/health-panel-expands-lung-cancer-screening-for-more-smokers/2021/03/09/2c70bd1e-80f1-11eb-be22-32d331d87530_story.html.

U.S. Preventive Services Task Force. (2021). Screening for Lung Cancer US Preventive Services Task Force Recommendation Statement. JAMA. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2777244.

U.S. Preventive Services Task Force. (2018). Grade Definitions. Retrieved from https://uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/grade-definitions.