New guidelines would nearly double lung cancer screenings, benefit more women and Black people

Lung cancer is No. 1 cause of cancer deaths in the U.S. for both men and women.

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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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