New Recommendations for Screening for Lung Cancer

The U.S. Preventive Services Task Force (USPSTF) has published a draft of potentially new recommendations for screening high-risk persons for lung cancer.  The USPSTF now recommends that smokers aged 55-80 who smoked at least one pack a day for 30 years should have a low-dose CT scan every year.   The draft recommendation is available for public comment until August 26, after which the recommendation is likely to be approved.

Screening normal healthy people for lung cancer (with traditional chest x-rays) is generally not done. In part, that’s because x-rays generally catch lung cancers too late for lifesaving treatment anyway.  In addition, x-rays sometimes produce false-positive results, leading to needless stress and unnecessary medical procedures.  On balance, then, the benefits of routine chest x-rays for detecting lung cancers just don’t outweigh the risks.  However, modern CT scans can pick up smaller tumors than traditional x-rays, leading to earlier and thus more effective treatment.  That tips the benefit/risk balance, at least for smokers at high risk of developing lung cancer.  The USPSTF estimates that screening high-risk smokers every year could save about 22,000 lives per year.

If the USPSTF’s draft recommendation is eventually approved, insurance companies will probably pay for annual CT scans for smokers who meet the screening criteria.  So will Medicare.